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[离心泵在心脏术后低心排血量综合征中的体外循环辅助]

[Extracorporeal circulatory assistance with centrifugal pumps in postcardiotomy low-output syndrome].

作者信息

Jakob H, Stürer A, Palzer B, Maass D, Iversen S, Oelert H

机构信息

Klinik für Herz-, Thorax- und Gefässchirurgie, Kliniken der Johannes Gutenberg-Universität Mainz.

出版信息

Helv Chir Acta. 1990 Oct;57(2):365-72.

PMID:2074201
Abstract

From 6/86 to 5/89 seven out of 1700 (0.4%) open heart patients had to be assisted with centrifugal pumps for postcardiotomy low cardiac output syndrome. In 4 cases a left ventricular assist device (LVAD) was used, one case each had a right ventricular assist device (RVAD), an extracorporeal membrane oxygenation (ECMO) and a biventricular assist device (BVAD) with ECMO and ultrafiltration. The last 3 patients were assisted non-pulsatile without intraaortic balloon counterpulsation (IABP) and no impairment of vital organ function was observed. Four out of 7 patients could be weaned from the assist device after a mean of 30 hours (0.5-48). Three patients became long-term survivors with 2 assisted non-pulsatile. Transesophageal echocardiography (TEE) was used to determine the timing for wean off and was found to be an important adjunct to the monitoring of filling--and systemic pressure.

摘要

从1986年6月至1989年5月,1700例心脏直视手术患者中有7例(0.4%)因术后低心排血量综合征需要使用离心泵辅助。其中4例使用了左心室辅助装置(LVAD),1例使用了右心室辅助装置(RVAD),1例使用了体外膜肺氧合(ECMO),1例使用了带有ECMO和超滤的双心室辅助装置(BVAD)。最后3例患者在无主动脉内球囊反搏(IABP)的情况下接受非搏动性辅助,未观察到重要器官功能受损。7例患者中有4例在平均30小时(0.5 - 48小时)后成功脱离辅助装置。3例患者长期存活,其中2例接受非搏动性辅助。经食管超声心动图(TEE)用于确定脱离辅助装置的时机,发现其是监测充盈和体循环压力的重要辅助手段。

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