EXTRACORPOREAL LIFE-SUPPORT FOR PATIENTS UNDERGOING PROLONGED EXTERNAL CARDIAC MASSAGE

被引：21

作者：

KUROSE, M

OKAMOTO, K

SATO, T

OGATA, K

YASUMOTO, M

TERASAKI, H

MORIOKA, T

机构：

[1] Division of Intensive and Critical Care Medicine, Department of Anesthesiology, Kumamoto University School of Medicine, Kumamoto

来源：

RESUSCITATION | 1993年 / 25卷 / 01期

关键词：

CARDIAC ARREST; PROLONGED CARDIAC MASSAGE; EXTRACORPOREAL LIFE SUPPORT;

D O I：

10.1016/0300-9572(93)90004-A

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

From November 1987 to February 1992, extracorporeal life support (ECLS) was used for four patients undergoing prolonged external cardiac massage following cardiac arrest. Their underlying diseases consisted of acute pulmonary embolism, pulmonary arterial thrombosis due to protein C deficiency, acute inferior left ventricular infarction accompanied by right ventricular infarction and thoracic contusion. After the initiation of ECLS, hemodynamic variables and metabolic acidosis improved in all of the cases. The case of pulmonary embolism and the case of acute myocardial infarction were successfully weaned from ECLS without complications. They were later discharged ambulatory from the hospital. The patient with pulmonary arterial thrombosis, who was comatose, became alert after the initiation of ECLS. However the patient finally died due to diffuse and massive pulmonary arterial thrombosis, which was probably related to protein C deficiency. The patient with thoracic contusion was also comatose before ECLS. He did not recover from the coma and died soon after the disconnection of ECLS. The latter two cases were suspected to have had irreversible organ failures not responsive to mechanical support of both circulation and respiration. We conclude that ECLS is a very useful method for patients requiring prolonged cardiac massage following cardiac arrest.

引用

页码：35 / 40

页数：6

共 14 条

[1]

Bartlett, Gazzaniga, Toomasian, Corwin, Roloff, Rucker, Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure, Ann Surg, 204, pp. 236-245, (1986)

[2]

Anderson, Attorri, Custer, Chapman, Bartlett, Extracorporeal membrane oxygenation for pediatric cardiopulmonary failure, J Thorac Cardiovasc Surg, 99, pp. 1011-1021, (1990)

[3]

Steinhorn, Green, Use of ECMO in the treatment of respiratory syncytial virus bronchiolitis, the national experience, 1983–1988, J Pediatr, 116, pp. 338-342, (1990)

[4]

Pennington, Merjavy, Codd, Swartz, Miller, Williams, Extracorporeal membrane oxygenation for patients with cardiogenic shock, Circulation, 70, pp. 130-137, (1984)

[5]

Meliones, Custer, Snedecor, Moler, O'Rourke, Delius, Extracorporeal life support for cardiac assist in pediatric patients Review of ELSO registry data, Circulation, 84, pp. 168-172, (1991)

[6]

Long, Rosenblum, Grady, Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass, Anesth Analg, 69, pp. 403-406, (1989)

[7]

Pretto, Safar, Saito, Stezoski, Kelsey, Cardiopulmonary bypass after prolonged cardiac arrest in dogs, Ann Emerg Med, 16, pp. 611-619, (1987)

[8]

Levine, Gorayeb, Safar, Abramson, Stezoski, Kelsey, Cardiopulmonary bypass after cardiac arrest and prolonged closed-chest CPR in dogs, Ann Emerg Med, 16, pp. 620-627, (1987)

[9]

Martin, Nowak, Carden, Eisiminger, Tomlanovich, Cardiopulomonary bypass vs. CPR as treatment for prolonged canine cardiopulmonary arrest, Ann Emerg Med, 16, pp. 628-636, (1987)

[10]

Carden, Martin, Nowak, Foreback, Tomlanovich, The effect of cardiopulmonary bypass resuscitation on cardiac arrest induced lactic acidosis in dogs, Resuscitation, 17, pp. 153-161, (1989)

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