Charlesworth Michael, Venkateswaran Rajamiyer, Barker Julian M, Feddy Lee
Department of Cardiothoracic Anaesthesia, University Hospital South Manchester, Southmoor Road, Manchester, M23 9LT, UK.
Cardiac and Transplant Surgeon, University Hospital South Manchester, Manchester, UK.
J Cardiothorac Surg. 2017 Dec 19;12(1):116. doi: 10.1186/s13019-017-0674-5.
Postcardiotomy cardiogenic shock (PCCS) is a rare but catastrophic syndrome that can occur following separation from cardiopulmonary bypass or at any time during the immediate postoperative course. The management of PCCS varies between clinicians, institutions and countries. The available evidence to guide this practice is limited. In their systematic review and meta-analysis, Khorsandi and colleagues report a synthesis of case-series pertinent to the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for PCCS. Whilst we acknowledge the potential survival benefit for carefully selected patients for what is ordinarily a condition with high mortality, we wish to comment on several aspects of the study in the context of its application to clinical practice.
心脏术后心源性休克（PCCS）是一种罕见但灾难性的综合征，可发生在体外循环脱离后或术后即刻的任何时间。PCCS的管理在临床医生、机构和国家之间存在差异。指导这种实践的现有证据有限。在他们的系统评价和荟萃分析中，科尔桑迪及其同事报告了一系列与使用静脉-动脉体外膜肺氧合（VA-ECMO）治疗PCCS相关的病例综合情况。虽然我们承认对于精心挑选的患者，在这种通常死亡率很高的疾病中使用VA-ECMO可能有生存益处，但我们希望在该研究应用于临床实践的背景下对几个方面发表评论。
