Cardiac resuscitation with percutaneous cardiopulmonary support

Rees, Michael R.; Browne, Tom; Sivananthan, U. M.; Whittaker, S.R.F.; Hick, D. G.; Tan, Lip Bun; Davies, G. A.

doi:10.1016/0140-6736(92)91711-g

Cited by 42 publications

(14 citation statements)

References 6 publications

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“…18 Patients suffering an unwitnessed arrest, in the terminal stage of malignancy or with cerebral hemorrhage and lacking treatment options are contraindicated for PCPS. 6,19 Survival rates strongly depend on appropriate patient selection, including age, diagnosis of underlying disease, subsequent treatment, underlying condition and duration of CPA before PCPS; 1,[3][4][5][6][7][8]10,[14][15][16][17]19 however, the appropriate indication, management and therapeutic strategy for using PCPS for CPA patients are controversial and have not been fully characterized. Furthermore, few reports have described the management details of PCPS.…”

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confidence: 99%

Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients

Aoyama

Imai

Kono

et al. 2009

Circ J

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Appropriate patient selection for PCPS in cases of O-CPA is likely to give a similar survival rate as for I-CPA. Patient selection and reversibility of the underlying disease and clinical state after starting PCPS affect the prognosis. Aggressive diagnosis and therapy for the underlying disease and prevention of complications associated with PCPS are essential factors in successful discharge of patients. Patients with an unknown etiology are not expected to fully recover, despite PCPS.

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confidence: 99%

Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients

Aoyama

Imai

Kono

et al. 2009

Circ J

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“…Once hemorrhagic complication occurs at the time of treatment with PCPS, a patient may easily fall into a critical condition because we use a large amount of anticoagulant. Without this patient's preserved cardiac function we would not have been able to stop the PCPS as an effective bridge for AMI patients with cardiogenic shock [6], so that hemorrhagic shock would have been promoted. It is thought that we have to perform each procedure with the greatest care in order not to further complicate the situation in any emergency.…”

Section: Discussionmentioning

confidence: 99%

Contrast media injection into right coronary artery caused thrombus extraction to aorta that may have resulted in left main trunk thrombosis

Ikeda

Inagaki

Fukuzawa

et al. 2011

Cardiovasc Interv and Ther

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A 59-year-old man with inferior acute myocardial infarction underwent an urgent coronary angiography and as a result a total occlusion of the ostial right coronary artery (RCA) was observed. Interestingly, the thrombus in the RCA clearly shortened within 2.3 s during the contrast media injection. While we prepared for percutaneous coronary intervention (PCI) of the RCA, ventricular fibrillation occurred and pulseless electrical activity continued in spite of repeated cardioversion. Despite no stenosis in the left main trunk (LMT) in the initial coronary angiography, the LMT was totally occluded. Following aspiration therapy on the LMT with percutaneous cardiopulmonary support, PCI of the RCA was performed. A coronary angiography should be carefully performed if a lot of thrombi exist in the coronary ostium because LMT embolism may have been caused by thrombus extraction from the RCA by contrast media injection.

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“…In addition, we also included eight patients who did not achieve revascularization; seven of the 8 patients finally expired during hospitalization. Although PCPS provides stable hemodynamic conditions, perfusion of the infarction-related coronary arteries was still not enough 18. Revascularization is considered practical for preserving myocardial viability in patients with AMI as a bridge to recovery 19.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Patients with Acute Myocardial Infarction Complicated by Severe Refractory Cardiogenic Shock Assisted with Percutaneous Cardiopulmonary Support

et al. 2014

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PurposeLimited data are available on the role of percutaneous cardiopulmonary support (PCPS) for the treatment of acute myocardial infarction (AMI) patients with cardiogenic shock. We investigated the clinical outcomes and predictors of in-hospital mortality after PCPS in patients with AMI complicated by severe refractory cardiogenic shock.Materials and MethodsFrom January 2004 to December 2011, we analyzed data from 96 consecutive AMI patients with cardiogenic shock assisted by a PCPS system. The primary outcome was in-hospital mortality. The predictors of in-hospital mortality were determined by a Cox proportional-hazards model.ResultsIn-hospital mortality occurred in 51 (53.1%) patients and 58 (60.4%) patients were able to be weaned from PCPS. Cardiopulmonary resuscitation (CPR) was performed in 61 (63.5%) patients before PCPS initiation. On multivariate analysis, age ≥67 years [adjusted hazard ratio (HR), 4.74; 95% confidence interval (CI), 2.27-9.93; p<0.001], CPR (adjusted HR, 2.32; 95% CI, 1.11-4.85; p=0.03), lactate clearance for 48 hours <70% (adjusted HR, 2.50; 95% CI, 1.04-6.05; p=0.041), and unsuccessful revascularization (adjusted HR, 3.57; 95% CI, 1.85-6.90; p=0.002) were independent predictors of in-hospital mortality after PCPS in patients with AMI complicated by cardiogenic shock.ConclusionIn spite of PCPS management, AMI patients complicated by severe refractory cardiogenic shock demonstrated high mortality. Older age, CPR, lower lactate clearance for 48 hours, and unsuccessful revascularization were independent predictors of in-hospital mortality.

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Cardiac resuscitation with percutaneous cardiopulmonary support

Cited by 42 publications

References 6 publications

Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients

Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients

Contrast media injection into right coronary artery caused thrombus extraction to aorta that may have resulted in left main trunk thrombosis

Clinical Outcomes of Patients with Acute Myocardial Infarction Complicated by Severe Refractory Cardiogenic Shock Assisted with Percutaneous Cardiopulmonary Support

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