Korean Circ J.  2006 Jan;36(1):11-16. 10.4070/kcj.2006.36.1.11.

Percutaneous Cardiopulmonary Support for Emergency In-Hospital Cardiac Arrest or Cardiogenic Shock

• Rhee I
• Gwon HC
• Choi J
• Sung K
• Lee YT
• Kwon SU
• Cho DK
• Lim SH
• Kim SW
• Lee SH
• Hong KP
• Park JE

• KMID: 1636372
• DOI: http://doi.org/10.4070/kcj.2006.36.1.11

Abstract

BACKGROUND AND OBJECTIVES
Percutaneous cardiopulmonary support (PCPS) provides hemodynamic stability for the treatment of patients suffering with cardiogenic shock or cardiac arrest, and it can be used in a wide variety of clinical settings without the need for chest exploration. In this study, we summarize a single center's experience with performing PCPS in the patients who suffered with severe cardiopulmonary failure.
SUBJECTS AND METHODS
We retrospectively reviewed 30 consecutive patients with cardiac arrest or severe cardiogenic shock who received PCPS for cardiac resuscitation from November 2003 to July 2005. The self-priming, heparin-coated circuit of the Emergency Bypass System(R) was used in all the patients. Cannulation was performed via the femoral artery and vein with using an arterial (17 to 21 French) and venous cannula (21 to 28 French), percutaneously or with a small incision.
RESULTS
The Indications for PCPS were: ischemic heart disease before coronary revascularization, myocardial disease, PCI-associated complications and post-operative hemodynamic collapse. Of the 30 patients we evaluated, 19 patients (63%) were successfully weaned off of the PCPS; 14 of these patients (47%) were later discharged from the hospital. For the survivors, the time interval from cardiac arrest or severe cardiogenic shock to the onset of PCPS was significantly shorter (p=0.01), and the urine output for the initial 24 hours was significantly higher (p=0.04).
CONCLUSION
This retrospective analysis demonstrates the effectiveness of using PCPS for the treatment of critically unstable patients with cardiac arrest or cardiogenic shock. Larger scale studies of PCPS are now needed to confirm these findings.

Keyword

Shock, cardiogenic; Cardiac arrest

MeSH Terms

Catheterization
Catheters
Emergencies*
Femoral Artery
Heart Arrest*
Hemodynamics
Humans
Myocardial Ischemia
Myocardial Revascularization
Resuscitation
Retrospective Studies
Shock, Cardiogenic*
Survivors
Thorax
Veins