Emergency cardiopulmonary bypass support in patients with cardiac arrest.
Emergency cardiopulmonary bypass support in patients with cardiac arrest.
复制标题
心脏骤停患者的紧急体外循环支持。
DOI：
10.1016/s0022-5223(19)36727-3
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
R. Emery
中科院分区：
文献类型：
--
作者：
M. Mooney;K. Arom;L. Joyce;J. Mooney;I. Goldenberg;Thomas J. Von Rueden;R. Emery
对11例常规复苏无效的心脏骤停患者进行了紧急经皮心肺转流支持。紧急经皮心肺转流支持用于5例患者，其中心脏骤停发生的心脏导管室（组1）和其他6例患者的心脏骤停（组II）的并发症的结果。将21 F插管和17 F插管经皮插入股静脉和动脉。流速为3 - 5 L/min，平均动脉压恢复至70 mm Hg（范围50 - 75）。所有11例患者的状态最初改善临床和血流动力学与经皮心肺转流。在第二组患者中，3例解剖结构不适合经皮腔内冠状动脉成形术或冠状动脉旁路移植术，无法脱离心肺支持，并死亡;其中3例患者接受了冠状动脉旁路移植术，2例存活。第一组5例患者均成功接受了冠状动脉旁路移植术并存活。在7名患有解剖学可矫正疾病的患者中，所有7名患者均已出院。如果采用常规治疗，几乎所有7名患者都会死亡。11例患者中有9例接受了心脏手术，其中7例存活。手术死亡率为22%，总生存率为64%。在随访（平均7个月）时，所有7名患者均存活，6名患者已恢复正常和积极的生活方式。总之，紧急经皮心肺转流支持是一种强大的复苏工具，可以稳定心源性休克和心脏骤停患者的病情，以便进行明确的干预。
Emergency percutaneous cardiopulmonary bypass support was instituted in 11 patients in cardiac arrest refractory to conventional resuscitation measures. Emergency percutaneous cardiopulmonary bypass support was used in five patients in whom cardiac arrest occurred as a result of a complication in the cardiac catheterization laboratory (group 1) and in six other patients in cardiac arrest (group II). A 21F cannula and a 17F cannula were percutaneously inserted into the femoral vein and artery. Flow rates of 3 to 5 L/min were achieved with restoration of mean arterial pressure to 70 mm Hg (range 50 to 75). The status of all 11 patients was improved initially both clinically and hemodynamically with percutaneous cardiopulmonary bypass. Of the group II patients, three had anatomy unsuitable for percutaneous transluminal coronary angioplasty or coronary bypass grafting, could not be weaned from cardiopulmonary support, and died; three of these patients had coronary artery bypass grafting and two survived. All five group I patients underwent successful coronary bypass grafting and survived. Of the seven patients with anatomically correctable disease, all seven were discharged from the hospital. With conventional management nearly all seven of these patients would have died. Nine of 11 patients underwent a cardiac operation and seven of the nine survived. The operative mortality rate was 22% and the overall survival rate was 64%. At follow-up (mean 7 months), all seven patients are alive and six have resumed a normal and active life-style. In conclusion, emergency percutaneous cardiopulmonary bypass support is a powerful resuscitative tool that may stabilize the condition of patients in cardiogenic shock and cardiac arrest to allow for definitive intervention.
DOI：
--
发表时间：
1989
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Allen,BS;Rosenkranz,E;Buckberg,GD;Davtyan,H;Laks,H;Tillisch,J;Drinkwater,DC
通讯作者：
Drinkwater,DC