Kamada M, Watanabe S, Fukuju T, Tsuru Y, Akimoto H, Iguchi A, Tabayashi K, Yokoyama H, Ohmi M
Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kyobu Geka. 2002 May;55(5):389-93.
We reviewed the cases of recurrent low output syndrome (LOS) after the weaning from mechanical circulatory support for postcardiotomy cardiogenic shock. Twelve patients were divide into 2 groups according to whether low output syndrome recurred or not, consisting of a recurrent low output syndrome (+) group [re-LOS (+) group, n = 6] and a recurrent low output syndrome (-) group [re-LOS (-) group, n = 6]. Between 2 groups, there was no statistical difference in preoperative left ventricular ejection fraction (LVEF), aortic closs-clamping time and cardiac index at the weaning from mechanical circulatory support. Only the LVEF at the weaning in the re-LOS (+) group was significantly less than that in the re-LOS (-) group (0.39 +/- 0.08 vs 0.62 +/- 0.19, p < 0.05). All patients in the re-LOS (-) group survived to discharge, while in the re-LOS (+) group, although 3 patients were re-supported by intra-aortic balloon pumping, 4 of 6 patients died of multiple organ failure and 2 survivors were in New York Heart Association class III. The results suggest that the key to survive to discharge after the weaning from mechanical circulatory support is whether the cardiac contraction could recover or not.
我们回顾了心脏术后心源性休克患者机械循环支持撤机后复发性低心排血量综合征（LOS）的病例。根据低心排血量综合征是否复发，将12例患者分为2组，即复发性低心排血量综合征（+）组[再发LOS（+）组，n = 6]和复发性低心排血量综合征（-）组[再发LOS（-）组，n = 6]。两组之间，术前左心室射血分数（LVEF）、主动脉阻断时间和机械循环支持撤机时的心指数无统计学差异。仅再发LOS（+）组撤机时的LVEF显著低于再发LOS（-）组（0.39±0.08对0.62±0.19，p<0.05）。再发LOS（-）组所有患者均存活至出院，而再发LOS（+）组中，尽管3例患者接受了主动脉内球囊反搏再次支持，但6例患者中有4例死于多器官功能衰竭，2例幸存者为纽约心脏协会Ⅲ级。结果表明，机械循环支持撤机后存活至出院的关键在于心脏收缩功能能否恢复。
