Title: The therapeutic effects of various circulatory support devices in acute cardiorespiratory function failure patients during perioperation of cardiosurgery
Abstract: Objective:To investigate the therapeutic effect of various circulatory assist devices in acute cardiorespiratory function failure patients during perioperation of cardiosurgery.Method:From January 2005 to December 2006,224 patients [54 female;mean age(57.7±14.1) years] received circulatory support for perioperative cardiorespiratory function failure at our ICU.Biventricular assist devices(BiVADs) was used in one patient for fulminant myocarditis as a direct bridge to heart transplantation,and 3 patients received a left ventricular assist device(LVAD) for postcardiotomy cardiac function failure.ECMO was established in 47 patients for postcardiotomy cardiorespiratory function failure.Venoarterial bypass was instituted in 45 for hemodynamic failure and venovenous in 2 patients for hypoxemia following cardiac surgery.Seven patients received IABP support during ECMO.173 patients received IABP support for perioperative cardiac function failure.The cardiac operations included coronary artery bypass grafting(n=150),coronary artery bypass grafting and remolding of left ventricle(n=21),coronary artery bypass grafting and valvular operation(n=8),valvular operation alone(n=26),heart transplantation(n=8),correction of congenital heart defects(n=7),and aortic operations(n=2).Result:In the VAD group,the patient successfully weaned from BiVADs but died of disseminated intravascular coagulation(DIC)after transplantation.One patient died on LVAD for heart failure.In the ECMO group,16 patients died on ECMO and 7 patients died after weaning because of multiple organ failure.In the IABP group,49 patients died with 18 patients survivaled to decannulation.The most common complications were infection(n=27),renal failure required renal replacement therapy(n=26),re-exploration for bleeding(n=23),limb ischemia(n=15)and central nervous system complication(n=7).Conclusion:Circulatory assist devices is an effective mechanical assistance method for treatment of perioperative cardiorespiratory failure.Adapted assist devices should be preferred according to patient's condition.Consideration should be given to instituting circulatory assist devices earlier if indication is confirmed.Improvement of management may result in improved outcomes for advanced cardiorespiratory function failure.
Publication Year: 2008
Publication Date: 2008-01-01
Language: en
Type: article
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot