Indication And Efficacy Of Percutaneous Cardiopulmonary Support In Patients With Out-Of-Hospital Cardiac Arrest
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Background and Purpose: Prognostic implications of intensive care with percutaneous cardiopulmonary support (POPS) remain to be clarified in patients with out-of-hospital cardiogenic cardiac arrest. We clinicaly surveyed the therapeutic efficacy of intensive care with PCPS. Methods: Subjects were 187 consecutive patients-128 males and 59 females, aged 3 to 94 years (mean: 65.5±16.3 years)-with cardiac arrest of cardiac etiology from April 1999 to March 2002. Results: (1) The rates of return of spontaneous circulation (ROSC), survival, and favorable neurological outcome in patients treated by PCPS (n=20 [11%]), percutaneous coronary intervention (n=10 [5%]), and brain protection by mild hypothermia (n=20 [11%]) were 32%, 14%, 9%, respectively. (2) Time to circulatory recovery by ROSC or PCPS in patients with favorable neurological outcome was short at a mean, 30.9 minutes. (3) Good recovery or moderate disability occurred in 35%, severe disability or a vegetative state in 15%, and death in 50% of patients treated with PCPS (n=20). Corresponding numbers in patients with ROSC without PCPS (n=21 excluding those with pulseless electrical activity or asystole on admission) were 38%, 19%, and 43%. No significant difference was seen among outcomes. Conclusion: Patients with early circulatory recovery can anticipate a favorable neurological outcome, and intensive care with PCPS appears to be most appropriate for those with cardiac arrest of cardiac etiology.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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