Document Detail


Mechanical cardiac support system for patients with postcardiotomy cardiogenic shock: analysis of risk factors for survival.
MedLine Citation:
PMID:  15141702     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Mechanical cardiac support system (MCSS) has been used for adult patients in postcardiotomy cardiogenic shock and has been shown to provide excellent oxygenation and hemodynamic support. However, MCSS has a number of disadvantages that include high incidence rate of complications (e.g. stroke, bleeding) and limited duration of sufficient support. The objective of this study is to identify perioperative and postoperative factors for survival in patients having MCSS. METHODS: From January 1991 to April 2001, MCSS has been applied to 22 adult patients in postcardiotomy cardiogenic shock. These patients' charts were retrospectively reviewed. RESULTS: Of 22 patients, 9 patients (41%) were successfully weaned, and 6 (27%) were hospital survivors. The duration of assist ranged from 21 to 211 hours (median 66 hours). In 7 (78%) out of 9 patients who could be weaned from MCSS, MCSS were required for less than 3 days. Major complications were reexploration for bleeding (18%), leg ischemia (45%), renal dysfunction (77%), liver dysfunction (59%), infection (31.8%), hypoxia due to lung dysfunction (36%) and cerebral dysfunction (41%). pH, base excess, HCO3-, urine output, transfused platelets at first 24 hours of MCSS and preoperative body surface area were significant predictors for survival. CONCLUSION: The indices of insufficient hemodynamic support such as progression of acidosis or poor urine output are significant predictors for early death. Early conversion from MCSS to long-term assist device, such as left ventricular assist device, should be considered when these factors are associated with poor cardiac recovery.
Authors:
Ken-ichi Imasaka; Munetaka Masuda; Tomohisa Oishi; Ichiro Shimizu; Toshiro Iwai; Takayoshi Kajihara; Yukihiro Tomita; Shigeki Morita; Kiminori Shiraishi; Hisataka Yasui
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai zasshi     Volume:  52     ISSN:  1344-4964     ISO Abbreviation:  Jpn. J. Thorac. Cardiovasc. Surg.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-05-14     Completed Date:  2004-06-29     Revised Date:  2005-02-01    
Medline Journal Info:
Nlm Unique ID:  100884261     Medline TA:  Jpn J Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  163-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acidosis / etiology
Adult
Aged
Assisted Circulation / adverse effects,  mortality*
Body Surface Area
Cardiac Surgical Procedures
Female
Heart-Assist Devices
Humans
Male
Middle Aged
Multiple Organ Failure / etiology
Oliguria / etiology
Postoperative Complications / therapy*
Prognosis
Retrospective Studies
Risk Factors
Shock, Cardiogenic / therapy*
Survival Rate
Time Factors
Comments/Corrections
Comment In:
Jpn J Thorac Cardiovasc Surg. 2004 Nov;52(11):548; author reply 548-9   [PMID:  15609651 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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