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Original Article
Percutaneous Cardiopulmonary Support Experience of a National University Hospital in Busan
Dong Hun Shin1, Min Jin Lee1, Hae Jung Na1, Sun Mi Jang1, Jun-Hyok Oh2
Kosin Medical Journal 2015;30(1):23-28.
DOI: https://doi.org/10.7180/kmj.2015.30.1.23
Published online: January 20, 2015

1Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Korea

2Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, Korea

Corresponding Author:Jun-Hyok Oh, Department Cardiclogy, Medical Research Institute, Pusan National University Hospital, 305, Gudeok-ro Seo-gu, Busan, Korea TEL: +82-51-240-7221 FAX: +82-51-247-5875 E-mail: jhoh724@hanmail.net
• Received: April 17, 2014   • Accepted: August 5, 2014

Copyright © 2015 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Cardiopulmonary support has been used to treat the patients with refractory cardiogenic shock since 1950s. In advent of portable system its use has been widened considerably. In this retrospective study, we report our single center experience concerning possible indications, complications and outcomes of percutanous cardiopulmonary support (PCPS)
  • Methods
    From January 2013 to March 2014, we searched the patients who were supported by PCPS system by reviewing the medical records in cardiology department at our Hospital. Infectious organism was limited to what was identified within 2 weeks after weaning of PCPS.
  • Results
    A total of 9 patients were supported by PCPS with CAPIOX CX® system (Terumo inc., Tokyo, Japan) initially for ST-segment elevation myocardial infarction/non ST-segment elevation myocardial infarction in 4 patients, myocarditis in 3 patients, valvular heart disease in 1 patient, and acute respiratory distress syndrome in 1 patient. The mean duration of PCPS support was 79.1±76.6 hours and 5 of them were recovered and discharged alive. All the patients needed transfusions of various forms of blood products. And there was one major stroke and one hyperbilirubinemia in related to PCPS treatment.
  • Conclusions
    PCPS treatment was a valuable means to treat the patients with cardiovascular collapse, but not without costs. Efforts to reduce its associated complications should be made to improve outcomes.
Table 1.
Patient characteristics
Patient No. Sex/Age (years) Diagnosis Risk factors Prior Stroke CPR Rhythm S BP before PC (mmHg) CPS Clinical outcome
1 M/68 STEMI HTN, Sm NSR 40 Death (cardiogenic)
2 M/55 Severe MR   + AFL 80 Recovery
3 M/53 Myocarditis HTN, Sm + IVR 70 Recovery
4 M/58 Myocarditis HTN CAVB 70 Recovery
5 M/81 STEMI HTN + CAVB 0 Death (cardiogenic)
6 F/67 ARDS, severe MS   + Afib 92 Death (sepsis)
7 F/72 STEMI HTN, DM + + NSR 60 Death(cardiogenic)
8 M/23 Viral myocarditis   NSR 70 Recovery
9 M/74 NSTEMI HTN, DM, Sm + Afib 70 Recovery

Afib = atrial fibrillation; AFL = atrial flutter; ARDS = acute respiratory distress syndrome; CAVB = complete AV block; CPR = cardiopulmonary resuscitation; DM = Diabetes mellitus; HTN = hypertension; IVR = idiopathic ventricular rhythm; MR = mitral valve regurgitation; MS = mitral valve stenosis; SBP = systolic blood pressure; Sm = smoking; STEMI = ST-segement elevation myocardia infarction.

Table 2.
PCPS characteristics
Pt. No. Type Cannulation site, artery Arterial catheter size, Fr Cannulation site, vein Venous catheter size, Fr Initial filter type Filter change Change time PCPS duration
1 VA RFA Edward Fem-Flex® 16 RFV Edward 18 C APIOX CX® → CAPIOX CX® 19 36
2 VA RFA 18 RFV Edward 20 NA 30
3 VA RFA 18 RFV BioMedicus multi-stage® 25 → Quadrox® 68 232
4 VA LFA 18 RFV 25 → Quadrox® 26 97
5 VA RFA 18 RFV 25 NA 14
          RIJV, Medtronic DLP ®, 17,        
6 VV LFA 16 RIJV, RFV BioMedicus multi-stage® 17, 21 Quadrox® NA 166
7 VA LFA 16 RFV BioMedicus multi-stage® 25 C APIOX CX® NA 6
8 VA LFA 16 LFV 25 NA 93
9 VA LFA 16 LFV 25 NA 38

Change time = Time from start of PCPS to change (hours); LFA = left femoral artery; NA = not applicable; PCPS = percutaneous cardiopulmonary support; PCPS duration = Duration of PCPS support (hrs); Pt. = patient; RFA = right femoral artery; RFV = right femoral vein; RIJV = right internal jugular vein; VA = venoarterial; VV = veno-veno.

Table 3.
Complications during PCPS
Patient No. Comlications Renal replacement therapy FFP T/F(u) RBC T/F(u) PLT T/F(u) Cryorecipitate (u) Cultured organism (blood)
1 bleeding (GI, Resp) + 16 19 32 12 none
2 none 10 10 16 12 none
3 bleeding (GI, access site) 10 7 0 0 none
4 stroke 0 8 6 0 S. epidermidis
5 None 0 2 0 0 none
6 hyperbilirubinemia, pneumothorax 27 17 114 0 none
7 None 0 8 0 0 None
8 None 4 1 10 0 None
9 Cannulation site bleeding 16 20 30 0 K.pneumoniae S.mitis/oralis

FFP = fresh frozen plasma; GI = gastrointestinal; K.pneumoniae = Klebsiella pneumonia; PLT = platelets; RBC = packed red blood cells; Resp = respiratory; S. epidermidis = staphylococcus epidermidis; S.mitis/oralis = Streptococcus mitis/oralis

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