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首页> 外文期刊>Artificial Organs >Extracorporeal life support: a simple and effective weapon for postcardiotomy right ventricular failure.
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Extracorporeal life support: a simple and effective weapon for postcardiotomy right ventricular failure.

机译：体外生命支持：一种简单有效的切开右心室衰竭的武器。

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Postcardiotomy right ventricular (RV) failure develops during the perioperative period following pulmonary hypertensive crisis or acute myocardial infarction. This study reports our institutional experience in treating these patients with extracorporeal life support (ECLS). Between June 2002 and July 2005, 46 adults were treated with ECLS for postcardiotomy shock. Acute RV failure was the cause of support in 14 (30%). Patient mean age was 55.7 +/- 15.4 years. Cardiac pathologies were valvular (n = 7), coronary (n = 1), combined coronary and valvular disease (n = 2), complex congenital heart (n = 2), aortic aneurysm (n = 1), and cardiomyopathy post heart transplant (n = 1). The triggers of RV failure were pulmonary hypertension (n = 6), RV infarction (n = 4), and not defined (n = 4). Patients were supported on ECLS for a mean duration of 71 +/- 52 h (range, 10-183 h). Major complications included acute renal failure requiring hemodialysis (n = 4), reexploration for bleeding (n = 2), and acute subdural hematoma (n = 1). Nine (64%) patients were successfully weaned from ECLS, and seven (50%) survived to discharge. Preexisting pulmonary hypertension had a favorable tendency for weaning, and acute renal failure requiring hemodialysis correlated with in-hospital mortality. ECLS is beneficial for treating postcardiotomy RV failure when conventional therapy is exhausted. As it can be deployed rapidly and does not require resternotomy for weaning, ECLS could be regarded as the first choice of mechanical support for postcardiotomy RV failure.
机译：在肺动脉高压危象或急性心肌梗死的围手术期期间，发生切开术后右心室（RV）衰竭。这项研究报告了我们在体外生命支持（ECLS）治疗这些患者方面的机构经验。在2002年6月至2005年7月之间，有46位成年人接受了ECLS切开术电击治疗。急性RV衰竭是14例（30％）支持的原因。患者平均年龄为55.7 +/- 15.4岁。心脏病理为瓣膜病（n = 7），冠状动脉病（n = 1），合并冠状动脉和瓣膜疾病（n = 2），先天性复杂心脏（n = 2），主动脉瘤（n = 1）和心脏移植后心肌病（n = 1）。 RV失败的诱因是肺动脉高压（n = 6），RV梗死（n = 4），但尚无明确定义（n = 4）。患者接受ECLS的平均持续时间为71 +/- 52小时（范围10-183小时）。主要并发症包括需要进行血液透析的急性肾衰竭（n = 4），再次探查出血（n = 2）和急性硬膜下血肿（n = 1）。 9例（64％）患者已成功从ECLS断奶，其中7例（50％）存活至出院。先前存在的肺动脉高压有断奶的有利趋势，而需要进行血液透析的急性肾功能衰竭与住院死亡率相关。当常规疗法用尽时，ECLS对于治疗切开性RV衰竭是有益的。由于ECLS可以快速部署，并且不需要进行再切开术即可断奶，因此ECLS可以被视为切开RV失败的机械支持的首选。

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