Mechanical support for postcardiotomy cardiogenic shock.
Mechanical support for postcardiotomy cardiogenic shock.
复制标题
心脏切开术后心源性休克的机械支持。
DOI：
--
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发表时间：
2000
影响因子：
2.5
通讯作者：
M. Oz
中科院分区：
文献类型：
--
作者：
D. Goldstein;M. Oz
心切开术后心源性休克（PCCS）的发病率和死亡率很高。尽管有主动脉内球囊反搏和正性肌力支持，一些PCCS患者仍有顽固性低心排血量。对于这些患者来说，更有效的心室辅助对于防止死亡至关重要。多种系统可用于PCCS患者的短期支持。无论使用何种器械，这些患者中只有25%存活并出院回家。然而，两种策略可能会改善PCCS的结果。一种是植入式辅助装置的长期支持，这可以实现最佳的心室卸载。不幸的是，并不是所有的心脏手术中心都提供这种类型的支持。因此，另一个策略是建立心切开术后转诊中心，提供长期支持或心脏移植。这样的中心将保存稀缺的供体器官，最大限度地提高心肌恢复的机会，并产生不仅适用于设备接受者，而且适用于不需要植入泵的重症心力衰竭患者的专业知识。
Postcardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality. Despite intraaortic balloon pump and inotropic support, some patients with PCCS continue to have a refractory low cardiac output. For these patients, more effective ventricular assistance is imperative to prevent death. Multiple systems are available for the short-term support of patients with PCCS. Regardless of the device employed, only 25% of these patients survive and are discharged home. Two strategies, however, may improve the outcome of PCCS. One is long-term support by an implantable assist device, which can allow optimal ventricular unloading. Unfortunately, not all cardiac surgery centers offer this type of support. Therefore, the other strategy is the creation of postcardiotomy referral centers that offer long-term support or heart transplantation. Such centers would conserve scarce donor organs, maximize the chance of myocardial recovery, and yield expertise applicable not only to device recipients but also to critically ill heart-failure patients who do not need an implantable pump.