Factors for Successful Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Low Cardiac Output Syndrome After Cardiovascular Surgery
スポンサーリンク
概要
- 論文の詳細を見る
The objective of this study was to analyze the early predictive factors for successful weaning from a percutaneous cardiopulmonary support system (PCPS) in patients with low cardiac output syndrome after cardiovascular surgery. A total of 938 patients underwent cardiovascular surgery with cardiopulmonary bypass (CPB) from January 1991 to September 2006 at Gunma University Hospital. Of these 938 patients, 13 (1.4%) required PCPS to maintain hemodynamics within 48 hours after surgery. The mean age of the 13 patients was 66 years (range, 45 to 86 years). Nine patients underwent open-heart surgery, 3 repair of a thoracic aortic aneurysm, and 1 a pericardiectomy. The patients were divided into 2 groups; group A (n = 4) who were removed from PCPS and group B (n = 9) who were not removed from PCPS. The conditions during the operation and after PCPS support were compared between the 2 groups. The mean age was higher, and operation time, CPB time, and aortic cross-clamping time were significantly (P < 0.05) longer in patients with PCPS than in those without PCPS. The mean PCPS time in all 13 patients was 190 ± 122 hours. The mean age was higher, and CPB time and the aortic cross-clamping time were longer in group B than in group A (NS). The mean duration of PCPS support was significantly (P < 0.05) shorter in group A than in group B (117 ± 42 hours versus 235 ± 136 hours). PCPS flow in group A could be reduced from 48 hours after PCPS induction. However, PCPC flow in group B could not be reduced, and there were significant (P < 0.05) differences in PCPS flow at 72 and 96 hours after starting PCPS. Significant (P < 0.05) differences in the absolute values of the APACHE II score, serum lactate levels, administered epinephrine dose, and levels of total bilirubin (T-Bil), serum creatinine (sCr), and lactate dehydrogenase (LDH) were found between the 2 groups within 96 hours after PCPS induction. In addition, there were significant (P < 0.05) differences in the rate of change compared with the baseline control value obtained prior to PCPS use in PCPS flow, APACHE II score, and levels of T-Bil, sCr, and LDH within 96 hours after PCPS induction. Significant differences in the rate of change of sCr and LDH were found, especially from the early phase after PCPS use, compared with other parameters. In the patients removed from PCPS, PCPS flow could be reduced within 48 hours after commencement of PCPS. Improvements in the APACHE II score and biochemical variables within 96 hours appear to be reliable prognostic factors for PCPS patients.
- インターナショナル・ハート・ジャーナル刊行会の論文
著者
-
TAKAHASHI Toru
Department of Pediatrics, Hirosaki University School of Medicine
-
OSHIMA Kiyohiro
Intensive Care Unit, Gunma University Hospital
-
KUNIMOTO Fumio
Intensive Care Unit, Gunma University Hospital
-
HINOHARA Hiroshi
Intensive Care Unit, Gunma University Hospital
-
TAJIMA Yukio
Supply Center, Gunma University Hospital
-
Kunimoto Fumio
Intensive Care Unit Gunma University Hospital
-
Tajima Yukio
Supply Center Gunma University Hospital
-
Oshima Kiyohiro
Intensive Care Unit Gunma University Hospital
-
Hinohara Hiroshi
Intensive Care Unit Gunma University Hospital
-
HAYASHI Yoshiro
Intensive Care Unit, Gunma University Hospital
-
TAKEYOSHI Izumi
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
-
KUWANO Hiroyuki
Intensive Care Unit, Gunma University Hospital
-
Mohara Jun
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
関連論文
- Three novel mutations of the fibrillin-1 gene and ten single nucleotide polymorphisms of the fibrillin-3 gene in Marfan syndrome patients
- Cloning and Characterization of the Novel Chimeric Gene p53/FXR2 in the Acute Megakaryoblastic Leukemia Cell Line CMK11-5
- KCNJ2 mutation in intractable ventricular arrhythmia with Andersen's syndrome
- Expression of Transcription Factors during Megakaryocytic Differentiation of CD34^+ Cells from Human Cord Blood Induced by Thrombopoietin
- Clinical and Histopathological Studies in Children With Supraventricular Tachycardia
- HISTOPATHOLOGICAL STUDY ON KAWASAKI DISEASE WITH SPECIAL REFERENCE TO THE RELATION BETWEEN THE MYOCARDIAL SEQUELAE AND REGIONAL WALL MOTION ABNORMALITIES OF THE LEFT VENTRICLE
- -0950-CLINICAL AND PATHOLOGIC ANALYSIS OF MYOCARDIAL DAMAGES FOLLOWING KAWASAKI DISEASE EMPLOYING ENDOMYOCARDIAL BIOPSY : THE 54th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- -49-CLINICAL INVESTIGATIONS ON THE INFANTS AND CHILDREN WITH IDIOPATHIC MULTIFORM VENTRICULAR PREMATURE CONTRACTIONS : Arrhythmias : FREE COMMUNICATIONS(I) : PROCEEDINGS OF THE 53th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- Progression from myelodysplastic syndrome with monosomy 7 to acute monoblastic leukemia with MLL gene rearrangement
- Respiratory Diseases and Working in a Copper or an Aluminum Product Plant:A Case Control Study by Using Medical Records