Die perkutan implantierbare Herz-Lungen-Maschine erweitert die therapeutischen und diagnostischen Möglichkeiten bei therapierefraktärem Kreislaufstillstand - Fallpräsentation und Übersicht

Ferrari, Markus; Wittmann, G.; Neumann, Stefan; Panzer, Wolfgang; Figulla, Hans R.

doi:10.1007/s003900050119

Cited by 12 publications

(4 citation statements)

References 28 publications

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“…This increases survival rates, as studies have shown. 9,10 The Lifebridge B2T ® is designed to be a short-term support with a maximal usage period of six hours.…”

Section: Introductionmentioning

confidence: 99%

Bridge to Life: The Lifebridge B2T® extracorporeal life support system in an in vitro trial

Maunz

Horisberger²,

Segesser³

2008

Perfusion

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Extracorporeal life support systems (ECLS) have become common in cardiothoracic surgery, but are still "Terra Incognita" in other medical fields due to the fact that perfusion units are normally bound to cardiothoracic centres. The Lifebridge B2T is an ECLS that is meant to be used as an easy and fast-track extracorporeal cardiac support to provide short-term perfusion for the transport of a patient to a specialized centre. With the Lifebridge B2T it is now possible to provide extracorporeal bypass for patients in hospitals without a perfusion unit. The Lifebridge B2T was tested on three calves to analyze the handling, performance and security of this system. The Lifebridge B2T safely can be used clinically and can provide full extracorporeal support for patients in cardiac or pulmonary failure. Flows up to 3.9 +/- 0.2l/min were reached, with an inflow pressure of -103 +/- 13mmHg, using a 21Fr. BioMedicus (Medtronic, Minneapolis, MN, USA) venous cannula. The "Plug and Play" philosophy, with semi-automatic priming, integrated check-list, a long battery time of over two hours and instinctively designed user interface, makes this device very interesting for units with high-risk interventions, such as catheterisation labs. If a system is necessary in an emergency unit, the Lifebridge can provide a high security level, even in centres not acquainted with cardiopulmonary bypass.

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“…This increases survival rates, as studies have shown. 9,10 The Lifebridge B2T ® is designed to be a short-term support with a maximal usage period of six hours.…”

Section: Introductionmentioning

confidence: 99%

Bridge to Life: The Lifebridge B2T® extracorporeal life support system in an in vitro trial

Maunz

Horisberger²,

Segesser³

2008

Perfusion

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“…Mitte der achtziger Jahre standen auf dieser Technik basierend erstmals mobile Herz-Lungen-Maschinen für den Notfalleinsatz mittels peripherer Kanülierung zur Verfügung (20). Durch den peripheren Anschluss dieser Systeme von den Leistengefäßen aus können so Patienten erfolgreich wiederbelebt und auch im Kreislaufstillstand weiteren diagnostischen und therapeutischen Maßnah-men zugeführt werden (8 lisieren waren, in der Regel keinerlei Überlebenschancen hatten (11). Durch die periphere Kanülierung der Leistengefäße besteht jedoch bei diesen Patienten die Möglichkeit, eine HerzLungen-Maschine unter ununterbrochener Fortführung der mechanischen Reanimationsmaßnahmen mit dem Patientenkreislauf zu verbinden (20).…”

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“…Durch die periphere Kanülierung der Leistengefäße besteht jedoch bei diesen Patienten die Möglichkeit, eine HerzLungen-Maschine unter ununterbrochener Fortführung der mechanischen Reanimationsmaßnahmen mit dem Patientenkreislauf zu verbinden (20). So können die Patienten im Kreislaufstillstand zunächst hämodynamisch stabilisiert und weiteren diagnostischen und therapeutischen Maßnahmen zugeführt werden, wodurch eine Steigerung der Überlebenschance auf bis zu 37% möglich ist (8). Seltenere Indikationen für den Einsatz mechanischer Herz-Kreislauf-Unterstützungssysteme stellen das Pumpversagen im Rahmen einer akuten Myokarditis sowie Infarkt-Komplikationen wie z.B.…”

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Mechanische Herz-Kreislauf-Unterstützung in der Kardiologie

Ferrari

Figulla²

2005

Dtsch med Wochenschr

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One out of 13 patients with an acute myocardial infarction is endangered of cardiogenic shock. In addition, acute valvular leakage, shunt vitiae, and acute myocarditis can lead to acute myocardial failure. As a therapeutic option, mechanical assist devices offer cardiac support and hemodynamic stabilization under these circumstances. The following minimal-invasive devices are used in cardiology and intensive care medicine: intra-aortic balloon pulsation (IABP), intra-vascular axial screw pumps, extra-corporal centrifugal pumps with and without additional membrane oxygenator. The IABP improves left ventricular function by a systolic reduction of the after-load, and an increase of diastolic blood pressure dependent on myocardial function. In contrast, axial screw pumps and centrifugal pumps can provide circulatory support independently of myocardial function. Mechanical assist devices can prevent irreversible damage not only by offering a reduction of myocardial work load, but also by improving organ perfusion in cardiogenic shock situations. Another indication for mechanical circulatory support depicts high-risk coronary angioplasty if the left ventricular ejection fraction is severely reduced or the target vessel supplies more than 50 % of vital myocardium. In case of irreversible heart failure, turbine pumps or centrifugal pumps offer a stabilization for the patient's transfer to a cardiac surgery center. They can also be used for bridging to heart transplantation in acute situations. Technical improvements will enhance the use of mechanical assist devices in the near future. Especially the development of portable emergency devices will enrich therapeutic possibilities in cardiology and intensive care medicine.

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