Patient selection and therapeutic strategy for emergency percutaneous cardiopulmonary system in cardiopulmonary arrest patients.
BACKGROUND
To clarify the appropriate application and therapeutic strategy for the percutaneous cardiopulmonary system (PCPS) in patients in cardiopulmonary arrest (CPA), the effects of the duration of cardiopulmonary resuscitation (CPR), diagnosis of underlying diseases, subsequent intervention and complications were retrospectively investigated for the correlation between discharge or death of patients. The patients were treated under an identical therapeutic PCPS protocol.


RESULTS
The 69 CPA patients [55 males (78.6%), 14 females; age, 55.0 +/-15.3 years; age range 15-79 years, 50 in-hospital CPA (I-CPA) and 19 out-of-hospital CPA (O-CPA) patients] were treated with emergency PCPS. The mean duration of CPR was 43.6 +/-37.4 min. Of 18 discharged patients (26.1%), 14 had I-CPA and 4 had O-CPA. Significant factors in the discharge of patients were confirmed diagnosis, subsequent treatment and prevention of complications associated with PCPS.


CONCLUSIONS
Appropriate patient selection for PCPS in cases of O-CPA is likely to give a similar survival rate as for I-CPA. Patient selection and reversibility of the underlying disease and clinical state after starting PCPS affect the prognosis. Aggressive diagnosis and therapy for the underlying disease and prevention of complications associated with PCPS are essential factors in successful discharge of patients. Patients with an unknown etiology are not expected to fully recover, despite PCPS.
Aoyama
Naoyoshi
N
Department of Cardio-angiology, Kitasato University School of Medicine, Sagamihara, Japan. aoyama@med.kitasato-u.ac.jp
Imai
Hiroshi
H
Kono
Ken
K
Kato
Shintaro
S
Fukuda
Naoto
N
Kurosawa
Toshiro
T
Soma
Kazui
K
Izumi
Tohru
T
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004630:Emergencies; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D018579:Patient Selection; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult