Document Detail


Predictive factors for successful weaning from percutaneous cardiopulmonary support in patients with cardiogenic shock complicating acute myocardial infarction.
MedLine Citation:
PMID:  22819038     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Percutaneous cardiopulmonary support (PCPS) is useful in the rescue of patients who have experienced severe cardiogenic shock. We investigated the predictive factors of survival among patients with cardiogenic shock requiring PCPS. METHODS AND SUBJECTS: We enrolled 29 patients (21 men and 8 women, 73±10 years old) with circulatory collapse complicating acute myocardial infarction (AMI) requiring PCPS. Fifteen patients could be weaned from PCPS and survived for more than 1 month (group A), while the other 14 patients could not (group B). We investigated the initial PCPS settings, and performed the appropriate laboratory tests. Hemodynamic data and arterial base excess (BE) values were recorded throughout the PCPS treatment. RESULTS: There was no difference in the laboratory test results or the left ventricular ejection fraction between the groups at the start of PCPS. PCPS flow (l/min) was significantly lower in group A than in group B at the 24th hour of PCPS (2.26±0.36 and 2.54±0.41, respectively). There were no differences in blood pressure between the groups. During the 24-h period prior to the end of PCPS, BE remained almost normal in group A. In group B, BE decreased continuously throughout the same period. BE values were significantly lower compared to those obtained in group A 12h prior to the end of PCPS. CONCLUSIONS: A reduction in PCPS flow without hemodynamic collapse may allow for successful weaning from PCPS. BE may be a potent factor in determining when to terminate PCPS.
Authors:
Daisuke Morisawa; Yoshiharu Higuchi; Katsuomi Iwakura; Atsunori Okamura; Motoo Date; Shigemiki Ohmiya; Masahiko Shibuya; Kenshi Fujii
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-19
Journal Detail:
Title:  Journal of cardiology     Volume:  -     ISSN:  1876-4738     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
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