| Japanese |
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| Title | PCPS装着時の回路内Svo2連続モニターと持続血液濾過による循環管理 |
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| Subtitle | 症例 |
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| Authors | 黒田真彦*, 堀部まゆみ*, 田嶋実*, 作間忠道**, 林康彦**, 山中健司***, 川西秀樹*** |
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| Authors(kana) | |
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| Organization | *あかね会土谷総合病院麻酔科, **あかね会土谷総合病院循環器内科, ***あかね会土谷総合病院人工臓器部 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 1 |
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| Page | 103-106 |
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| Year/Month | 1996/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」PCPS(percutaneous cardiopulmonary support system)を急性心筋梗塞による心原性ショック症例に用いた. その適正潅流量の目安として, PCPS脱血側で非観血的に混合静脈血酸素飽和度(Svo2-CPB)連続モニターを使用し, 循環管理を行った. Svo2-CPBが60%以上を目標に潅流量を調節し, PCPSから51時間後に離脱できた. また合併した腎不全に対し, PCPS回路内に持続血液濾過装置(CHF)を組み込むことで水分, 栄養管理に余裕ができた. PCPS回路内にSvo2-CPBモニター, CHFを組み込み使用することは有用である. 「はじめに」最近, 急性心不全の治療として経皮的心肺補助法(PCPS)が臨床応用されている. しかし, 装着中の管理は循環動態のみならず諸臓器機能および水, 電解質管理など多くの問題を有しており離脱, 社会復帰例が少ないのが現状である. 特に装着中の循環管理に際しては, 混合静脈血酸素飽和度を含めた肺動脈カテーテル等の従来のモニターでは適確な情報を得ることは困難である. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Percutaneous cardiopulmonary bypass support, Adequate perfusion rate, Continuous Svo2 monitor, Continuous hemofiltration, Acute myocardial infarction |
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| English |
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| Title | Circulatory Management by Continuous Svo2 Monitoring and Continuous Hemofiltration During Percutaneous Cardiopulmonary Bypass Support |
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| Subtitle | |
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| Authors | Masahiko Kuroda*, Mayumi Horibe*, Minoru Tajima*, Tadamichi Sakuma**, Yasuhiko Hayashi**, Kenji Yamanaka***, Hideki Kawanishi*** |
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| Authors(kana) | |
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| Organization | *Departments of Anesthesia, Akane-Foundation Tsuchiya General Hospital, **Cardioliogy, Akane-Foundation Tsuchiya General Hospital, ***Artificial Internal Organs, Akane-Foundation Tsuchiya General Hospital |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 1 |
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| Page | 103-106 |
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| Year/Month | 1996/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We treated a 74-year-old male of acute myocardial infarction with cardiogenic shock using percutaneous cardiopulmonary bypass support (PCPS). A spectroscopic sensor for the continuous oxygen saturation measuring system was incorporated in the venous outlet site of the PCPS circuit. Adequate perfusion of PCPS was assessed by Svo2. The Svo2 value was 41-70 % at a flow rate of 2.0-3.1 l/min. We adjusted the perfusion rate to maintain Svo2 above 60 %. After 40 hours, Svo2 remained above 60 %, and hemodynamics became stable. We started to reduce the PCPS flow gradually, and he was weaned from PCPS after 51 hours. We often encountered acute renal failure during PCPS management. It was easy to control the water and nutritional balance using continuous hemofiltration with PCPS. We considered it useful to use a continuous Svo2 monitor in the PCPS circuit, and continuous hemofiltration with PCPS. (Cire Cont 17：103〜106, 1996) |
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| Practice | Basic medicine |
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| Keywords | Percutaneous cardiopulmonary bypass support, Adequate perfusion rate, Continuous Svo2 monitor, Continuous hemofiltration, Acute myocardial infarction |
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