Japanese
Title緊急PCPS駆動12例の臨床経験
Subtitle原著
Authors森下篤, 島倉唯行, 野々山真樹, 高崎泰一
Authors(kana)
Organization福山循環器病院心臓血管外科
Journal循環制御
Volume22
Number1
Page14-18
Year/Month2001/
Article原著
Publisher日本循環制御医学会
Abstract「要旨」急性循環不全に対する強力な補助手段として全世界中で繁用されているPCPSの内, EMERSAVE(R)による緊急PCPS駆動12例を検討した. 離脱例は6例(50%)であり, 内5例は生存退院した. 下肢虚血や出血などの合併症は3例(25%)で全て非離脱例であった. 特に, 左主幹部病変や大動脈弁狭窄症などの急性循環虚脱症例に対し, 緊急手術までの橋渡しとしてPCPSを導入する事は有用であった. さらに, 開心術後LOSに対するPCPS駆動時における左室減圧の不十分性を経験し, IABP以外の左室補助効果を期待できる補助手段の重要性を再確認した. 全体での離脱率は50%と, ほぼ満足できる結果であった. 「はじめに」経皮的心肺補助(Percutaneous Cardiopulmonary Support；PCPS)は, 1983年にPhillipsらが発表して以来, 急性循環不全に対する強力な補助手段として活躍してきた. その適応も, 急性心筋梗塞などの心原性ショック, 致死性不整脈, 重症呼吸不全, 開心術後人工心肺離脱困難症例などの緊急駆動から, 胸腹部大動脈瘤手術時及び心拍動下バイパス術時の循環補助のような駆動にまで多方面に渡っている.
Practice基礎医学・関連科学
KeywordsPercutaneous cardiopulmonary support, EMERSAVE, Acute circulatory collapse, Postcardiotomy cardiogenic shock, Ischemia of the lower extremities
English
TitleEmergent Applications of Percutaneous Cardiopulmonary Support (EMERSAVE)
SubtitleOriginal article
AuthorsAtsushi Morishita, Tadayuki Shimakura, Masaki Nonoyama, Taiichi Takasaki
Authors(kana)
OrganizationDepartment of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital
JournalCirculation Control
Volume22
Number1
Page14-18
Year/Month2001/
ArticleOriginal article
PublisherJapan Society of Circulation Control
AbstractThe percutaneous cardiopulmonary support (PCPS) has widely applied as a device of mechanical circulatory support to the cardiogenic shock. The aim of this study was to assess the efficacy of PCPS in 12 cases of emergent applications of the EMERSAVE(R) From January 1996 to June 2000, we were able to wean 50% of patients from the EMERSAVE(R), and 41.7% were discharged from the hospital. The major morbidity was due to ischemia of the lower extremities (25%). These results suggested that it was important to initiale the PCPS immediately and bridge to the emergency operation in critical cases of acute circulatory collapse due to the deterioration of aortic stenosis, acute myocardial infarction, and so on. Furthermore, we experienced the insufficient unloading of the left ventricle under performing PCPS and intraaortic balloon pump (IABP) by transesophageal echocardiography for the postcardiotomy cardiogenic shock. The additional method prividing left ventricular unloading might be effective for promoting the recovery of left ventricle under the conventional method of PCPS and IABP.
PracticeBasic medicine
KeywordsPercutaneous cardiopulmonary support, EMERSAVE, Acute circulatory collapse, Postcardiotomy cardiogenic shock, Ischemia of the lower extremities

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