Teirstein P S
Division of Cardiology, Scripps Clinic and Research Foundation, La Jolla, California.
Am J Cardiol. 1992 May 7;69(15):19F-21F. doi: 10.1016/0002-9149(92)91178-7.
Cardiopulmonary support (CPS) has been shown to be a useful addition to interventional cardiology when considering alternatives for high-risk patients. Cardiopulmonary support systems are capable of up to 6 liters/min output and can be used prophylactically to prevent hemodynamic collapse following balloon occlusions or acute vessel closure. The technique, supported angioplasty, results in reductions of preload and afterload and allows prolonged balloon inflations in critical coronary vessels. Although it provides excellent support for most high-risk patients, CPS is a technically challenging and expensive procedure associated with significant patient morbidity. Standby CPS patients are prepared for institution of CPS, but bypass is not actually initiated unless the patient sustains irreversible hemodynamic compromise. In this study, standby and prophylactic patients had comparable success and major complication rates, but procedural morbidity was more frequent in prophylactic patients. Further study will better define appropriate patient selection for standby versus prophylactic CPS.
在考虑为高危患者提供替代方案时，心肺支持（CPS）已被证明是介入心脏病学的一项有用补充。心肺支持系统的输出量可达每分钟6升，可预防性用于防止球囊闭塞或急性血管闭塞后发生血流动力学崩溃。这种技术，即支持性血管成形术，可降低前负荷和后负荷，并允许在关键冠状动脉中延长球囊充气时间。尽管CPS为大多数高危患者提供了出色的支持，但它是一项技术上具有挑战性且昂贵的操作，会给患者带来显著的发病率。备用CPS患者为实施CPS做好准备，但除非患者出现不可逆的血流动力学损害，否则实际上不会启动体外循环。在本研究中，备用和预防性应用CPS的患者成功率和主要并发症发生率相当，但预防性应用CPS的患者手术发病率更高。进一步的研究将更好地确定备用与预防性应用CPS的合适患者选择标准。
