Document Detail


Successful mechanical circulatory support for noncoronary shock.
MedLine Citation:
PMID:  1540599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mechanically assisted recovery from shock and long-term survival of nontransplant patients with acute noncoronary myocardial decompensation have not been previously reported. We treated nine patients (aged 8 to 53 years) who were referred with acute nonischemic cardiogenic shock (pulmonary capillary wedge greater than 20, cardiac index less than 1.5 L/min/m2, mean blood pressure less than 60 mm Hg, ejection fraction less than 0.3%). Eight patients had viral prodromes, and one patient was peripartum. All patients' lungs were mechanically ventilated, and pharmacologic support failed in all patients. Two patients received steroids. All received mechanical circulatory support. Seven were initially supported with intraaortic balloon counterpulsation pumps. Two patients recovered with intraaortic balloon counterpulsation pumps alone (3 days and 4 days). Four patients received left ventricular assist devices (3, 7, 10, and 79 days), and two received biventricular support devices (10 days and 14 days). One patient was supported with extracorporeal femoral vein-to-femoral artery bypass for 6 days. Four patients required dialysis (4 days to 5 weeks). Seven patients underwent myocardial biopsies, of which three demonstrated acute myocarditis. All patients recovered ventricular function (ejection fraction greater than 0.55%), and all are New York Heart Association functional class I, 7 months to 4 1/2 years after support. Mechanical circulatory assist devices may be lifesaving for patients with acute nonischemic myocardial decompensation. Patients should be supported for at least 2 weeks before transplantation is considered.
Authors:
W P Dembitsky; C H Moore; W L Holman; B E Jaski; R J Moreno-Cabral; R M Adamson; P O Daily; C E Moreno-Cabral
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  11     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:    1992 Jan-Feb
Date Detail:
Created Date:  1992-04-06     Completed Date:  1992-04-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  129-35     Citation Subset:  IM    
Affiliation:
Sharp Memorial Hospital, San Diego, Calif.
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MeSH Terms
Descriptor/Qualifier:
Adult
Child
Counterpulsation
Female
Heart Transplantation
Heart-Assist Devices*
Humans
Intra-Aortic Balloon Pumping*
Male
Middle Aged
Resuscitation / methods
Risk Factors
Shock, Cardiogenic / mortality,  therapy*
Time Factors

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


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