皮膚経由の心肺支援による心臓蘇生
M R Rees1, T Browne, U M Sivananthan
1Cardiac Research Unit, Killingbeck Hospital, Leeds, UK.
Lancet (London, England)
|August 29, 1992
まとめ
皮膚経由の心肺サポート (CPS) は,心停止の患者を安定させ,冠動脈血管新生術を可能にすることができます. CPSは,心臓発作性ショックでの生存率を向上させなかったが,リバスカライゼーションを受けている心臓発作患者のために有望な結果を示した.
科学分野:
- 心臓病学 心臓病学
- 心血管外科手術についてです.
- クリティカルケア・メディシン
背景:
- 従来の蘇生は,重度の血液動力学的不安定性の患者でしばしば失敗します.
- 皮膚経由の心肺支柱 (CPS) は,重大な心疾患の発生時に血液動力学的安定性を維持するための潜在的な解決策を提供します.
研究 の 目的:
- 心臓発作ショックや心停止を経験している患者におけるCPSの有効性を評価する.
- CPSのサポートの下で皮膚経冠動脈介入 (PCI) を行うことの実現可能性を評価する.
主な方法:
- 9人の患者は,従来の蘇生が失敗したためにCPSを受けた (4人の心臓発作ショック,5人の心臓発作停止).
- 血液動力学的パラメータ (平均動脈内圧,流量) は,CPS.の際にモニタリングされた.
- 冠動脈血管新生手術は,CPSを受けている間に,適格な患者に実施されました.
主要な成果:
- 心臓発作性ショック患者では,CPSは平均動脈圧 (84 mm Hg) を維持したが,生存率は0%であった.
- 心停止の患者では,CPSは5人全員でPCIを成功させ,平均高血圧 (95mmHg) を達成した.
- 5人の心停止患者のうち4人は生存し,2人は12ヶ月で健康で生き延びました.
結論:
- CPSは,心停止の患者に血液動力学的サポートを提供し,冠動脈血管新生手術の成功を促進することができます.
- CPSは心臓発作性ショックでの生存を向上させなかったが,PCIを受けた心停止患者での生存の利点を実証した.
- CPSは,緊急の再血管化を要求する耐性心イベントを有する選択された患者にとって貴重なツールである可能性があります.
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