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使用Impella救治院外心脏骤停患者：三例病例报告

Saving patients with out-of-hospital cardiac arrest using Impella: three case reports.

作者信息

Aida Kenta, Azuma Kazunari, Ishii Yuri, Suzuki Shoji, Oda Jun

机构信息

Department of Emergency and Critical Care Medicine Tokyo Medical University Tokyo Japan.

出版信息

Acute Med Surg. 2020 Sep 8;7(1):e564. doi: 10.1002/ams2.564. eCollection 2020 Jan-Dec.

DOI:10.1002/ams2.564
PMID:32995019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7507025/
Abstract

BACKGROUND

The efficacy of Impella for patients with out-of-hospital cardiac arrest is unknown. We report the cases of three patients with cardiogenic out-of-hospital cardiac arrest who received hemodynamic support with Impella.

CASE PRESENTATION

Two patients, Case 2 and Case 3, received concomitant treatment with venoarterial extracorporeal membrane oxygenation and Impella. Percutaneous coronary intervention was undertaken in two patients, Case 1 and Case 3. Two patients, Case 1 and Case 3, showed favorable neurological function with the Glasgow-Pittsburgh cerebral performance and overall performance categories score of 1 at discharge.

CONCLUSION

These findings suggest that Impella is effective in patients with out-of-hospital cardiac arrest. Further studies are required to understand the use of Impella for patients with out-of-hospital cardiac arrest.

摘要

背景

体外膜肺氧合（Impella）对院外心脏骤停患者的疗效尚不清楚。我们报告了3例心源性院外心脏骤停患者接受Impella血流动力学支持的病例。

病例介绍

病例2和病例3这2例患者同时接受了静脉-动脉体外膜肺氧合和Impella治疗。病例1和病例3这2例患者接受了经皮冠状动脉介入治疗。病例1和病例3这2例患者出院时格拉斯哥-匹兹堡脑功能和总体功能分类评分为1，神经功能良好。

结论

这些发现表明，Impella对院外心脏骤停患者有效。需要进一步研究以了解Impella在院外心脏骤停患者中的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/31bba644ec4c/AMS2-7-e564-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/d9f785179aab/AMS2-7-e564-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/884905a4806b/AMS2-7-e564-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/31bba644ec4c/AMS2-7-e564-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/d9f785179aab/AMS2-7-e564-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/884905a4806b/AMS2-7-e564-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5021/7507025/31bba644ec4c/AMS2-7-e564-g003.jpg

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本文引用的文献

1
Impella use in acute myocardial infarction complicated by cardiogenic shock and cardiac arrest: Analysis of 10 years registry data.Impella 在伴心原性休克和心脏骤停的急性心肌梗死中的应用：10 年注册数据分析。
Resuscitation. 2019 Jul;140:178-184. doi: 10.1016/j.resuscitation.2019.04.022. Epub 2019 Apr 19.
2
Concomitant implantation of Impella on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock.在静脉-动脉体外膜肺氧合（VA-ECMO）的基础上同时植入 Impella 可能会提高心源性休克患者的生存率。
Eur J Heart Fail. 2017 Mar;19(3):404-412. doi: 10.1002/ejhf.668. Epub 2016 Oct 6.
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Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study.
体外心肺复苏与常规心肺复苏治疗院外心脏骤停成人患者的前瞻性观察研究。
Resuscitation. 2014 Jun;85(6):762-8. doi: 10.1016/j.resuscitation.2014.01.031. Epub 2014 Feb 12.
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Minimally invasive left-heart decompression during venoarterial extracorporeal membrane oxygenation: an alternative to a percutaneous approach.静脉-动脉体外膜肺氧合期间的微创左心减压：经皮方法的替代方案
Interact Cardiovasc Thorac Surg. 2010 May;10(5):672-4. doi: 10.1510/icvts.2009.228346. Epub 2010 Feb 5.
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Effects of mechanical left ventricular unloading by Impella on left ventricular dynamics in high-risk and primary percutaneous coronary intervention patients.经皮机械左心室辅助装置对高危和直接经皮冠状动脉介入治疗患者左心室动力学的影响。
Catheter Cardiovasc Interv. 2010 Feb 1;75(2):187-94. doi: 10.1002/ccd.22263.