體外膜肺氧合聯合主動脈內球囊反搏在心臟術后的應用_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

周小宇 , 梁振興 , 程行東 , 郭炯 ,  徐敬

鄭州大學第一附屬醫院心外三科（鄭州 450000）;

Corresponding?author：

徐敬, Email: xujing00111@sina.com

Keywords：

體外膜肺氧合; 主動脈內球囊反搏; 急性心力衰竭; 心臟術后

DOI：

10.7507/1007-4848.201801018

Video：

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目的探討體外膜肺氧合聯合主動脈內球囊反搏術在心臟術后急性心力衰竭中的應用。方法回顧性分析 2012 年 10 月至 2017 年 10 月我院心外三科因急性心力衰竭接受體外膜肺氧合聯合主動脈內球囊反搏治療 38 例患者的臨床資料，探索聯合應用在心臟術后中的作用。男 24 例、女 14 例，平均年齡（58±11）歲。結果 24 例患者成功撤離機械輔助裝置，其中 16 例患者存活出院。死亡組腎功能衰竭的發生率顯著高于生存組，差異有統計學意義。在不能脫機組的患者中，混合靜脈血氧飽和度未見明顯好轉。結論體外膜肺氧合聯合主動脈內球囊反搏可能具有協同作用，在心臟術后急性心力衰竭的治療中起到一定的輔助作用。

Citation： 周小宇, 梁振興, 程行東, 郭炯, 徐敬. 體外膜肺氧合聯合主動脈內球囊反搏在心臟術后的應用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(1): 101-105. doi: 10.7507/1007-4848.201801018 Copy

1.	Hedayati N, Sherwood JT, Schomisch SJ, et al. Circulatory benefits of diastolic counterpulsation in an ischemic heart failure model after aortomyoplasty. J Thorac Cardiovasc Surg, 2002, 123(6): 1067-1073.
2.	Dirusso GB, Martin GR. Extracorporeal membrane oxygenation for cardiac disease: No longer a mistaken diagnosis. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005, 8(1): 34-40.
3.	Schmidt M, Tachon G, Devilliers C, et al. Blood oxygenation and decarboxylation determinants during venovenous ECMO for respiratory failure in adults. Intensive Care Medicine, 2013, 39(5): 838-846.
4.	Stulak JM, Dearani JA, Burkhart HM, et al. ECMO cannulation controversies and complications. Semin Cardiothorac Vasc Anesth, 2009, 13(3): 176.
5.	Bahekar A, Singh M, Singh S, et al. Cardiovascular outcomes using intra-aortic balloon pump in high-risk acute myocardial infarction with or without cardiogenic shock: a meta-analysis. J Cardiovasc Pharmacol Ther, 2012, 17(1): 44.
6.	Vohra HA, Dimitri W R. Elective intraaortic balloon counterpulsation in high-risk off-pump coronary artery bypass grafting. J Card Surg, 2006, 21(1): 1-5.
7.	Mcenany MT, Kay HR, Buckley MJ, et al. Clinical experience with intraaortic balloon pump support in 728 patients. Circulation, 1978, 58(2): 124-132.
8.	Wernovsky G, Wypi JD, Jonas RA, et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest. Circulation, 1995, 92(8): 2226-2235.
9.	Bisdas T, Beutel G, Warnecke G, et al. Vascular complications in patients undergoing femoral cannulation for extracorporeal membrane oxygenation support. Ann Thorac Surg, 2011, 92(2): 626-631.
10.	Pieri M, Turla OG, Calabrò MG, et al. A new phosphorylcholine-coated polymethylpentene oxygenator for extracorporeal membrane oxygenation: a preliminary experience. Perfusion, 2013, 28(2): 132-137.
11.	Zangrillo A, Landoni G, Biondi-zoccai G, et al. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc, 2013, 15(3): 172-178.
12.	Dosluoglu HH, Dryjski ML. External femorofemoral bypass to relieve acute leg ischemia during circulatory assist. Vascular, 2004, 12(3): 198-201.
13.	Kasirajan V, Simmons I, King J, et al. Technique to prevent limb ischemia during peripheral cannulation for extracorporeal membrane oxygenation. Perfusion, 2002, 17(6): 427.
14.	Marasco S F, Lukas G, Mcdonald M, et al. Review of ecmo (extra corporeal membrane oxygenation) support in critically ill adult patients. Heart Lung Circ, 2008, 17(Supplement 4): S41-S47.
15.	Cheng JM, Valk SD, Denuil C A, et al. Usefulness of intra-aortic balloon pump counterpulsation in patients with cardiogenic shock from acute myocardial infarction. Am J Cardiol, 2009, 104(3): 327-332.
16.	Prondzinsky R, Lemm H, Swyter M, et al. Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK Trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med, 2010, 38(1): 152-160.
17.	Chang SN, Hwang JJ, Chen YS, et al. Clinical experience with intra-aortic balloon counterpulsation over 10 years: a retrospective cohort study of 459 patients. Resuscitation, 2008, 77(3): 316-324.
18.	Gill BS, Nevillehlkhan AM, Jr CC, et al. Delayed institution of extracorporeal membrane oxygenation is associated with increased mortality rate and prolonged hospital stay. J Pediatr Surg, 2002, 37(1): 7-10.
19.	Madershahian N, Wippermann J, Liakopoulos O, et al. The acute effect of IABP-induced pulsatility on coronary vascular resistance and graft flow in critical ill patients during ECMO. J Cardiovasc Surg, 2011, 52(3): 411-418.
20.	Gao ZW, Huang YZ, Zhao HM, et al. Impact of intra-aortic balloon counterpulsation on prognosis of patients with acute myocardial infarction: A meta-analysis. Acta Cardiologica Sinica, 2017, 33(6): 567-577.
21.	Sjauw KD, Engstrom AE, Vis MM, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J, 2009, 30(4): 459-468.
22.	Ye L, Zheng M, Chen Q, et al. Effects of intra-aortic balloon counterpulsation pump on mortality of acute myocardial infarction. PLoS One, 2014, 9(9): e108-e356.
23.	Ma P, Zhang Z, Song T, et al. Combining ECMO with IABP for the treatment of critically iii adult heart failure patients. Heart Lung Circ, 2014, 23(4): 363-368.
24.	Schroeter T, Vollroth M, Hobartner M, et al. Influence of ECMO and IABP on coronary blood flow. Valuable combination or waste of resources? Med Klin Intensivmed Notfmed, 2015, 110(3): 210-216.

1. Hedayati N, Sherwood JT, Schomisch SJ, et al. Circulatory benefits of diastolic counterpulsation in an ischemic heart failure model after aortomyoplasty. J Thorac Cardiovasc Surg, 2002, 123(6): 1067-1073.
2. Dirusso GB, Martin GR. Extracorporeal membrane oxygenation for cardiac disease: No longer a mistaken diagnosis. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005, 8(1): 34-40.
3. Schmidt M, Tachon G, Devilliers C, et al. Blood oxygenation and decarboxylation determinants during venovenous ECMO for respiratory failure in adults. Intensive Care Medicine, 2013, 39(5): 838-846.
4. Stulak JM, Dearani JA, Burkhart HM, et al. ECMO cannulation controversies and complications. Semin Cardiothorac Vasc Anesth, 2009, 13(3): 176.
5. Bahekar A, Singh M, Singh S, et al. Cardiovascular outcomes using intra-aortic balloon pump in high-risk acute myocardial infarction with or without cardiogenic shock: a meta-analysis. J Cardiovasc Pharmacol Ther, 2012, 17(1): 44.
6. Vohra HA, Dimitri W R. Elective intraaortic balloon counterpulsation in high-risk off-pump coronary artery bypass grafting. J Card Surg, 2006, 21(1): 1-5.
7. Mcenany MT, Kay HR, Buckley MJ, et al. Clinical experience with intraaortic balloon pump support in 728 patients. Circulation, 1978, 58(2): 124-132.
8. Wernovsky G, Wypi JD, Jonas RA, et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest. Circulation, 1995, 92(8): 2226-2235.
9. Bisdas T, Beutel G, Warnecke G, et al. Vascular complications in patients undergoing femoral cannulation for extracorporeal membrane oxygenation support. Ann Thorac Surg, 2011, 92(2): 626-631.
10. Pieri M, Turla OG, Calabrò MG, et al. A new phosphorylcholine-coated polymethylpentene oxygenator for extracorporeal membrane oxygenation: a preliminary experience. Perfusion, 2013, 28(2): 132-137.
11. Zangrillo A, Landoni G, Biondi-zoccai G, et al. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation. Crit Care Resusc, 2013, 15(3): 172-178.
12. Dosluoglu HH, Dryjski ML. External femorofemoral bypass to relieve acute leg ischemia during circulatory assist. Vascular, 2004, 12(3): 198-201.
13. Kasirajan V, Simmons I, King J, et al. Technique to prevent limb ischemia during peripheral cannulation for extracorporeal membrane oxygenation. Perfusion, 2002, 17(6): 427.
14. Marasco S F, Lukas G, Mcdonald M, et al. Review of ecmo (extra corporeal membrane oxygenation) support in critically ill adult patients. Heart Lung Circ, 2008, 17(Supplement 4): S41-S47.
15. Cheng JM, Valk SD, Denuil C A, et al. Usefulness of intra-aortic balloon pump counterpulsation in patients with cardiogenic shock from acute myocardial infarction. Am J Cardiol, 2009, 104(3): 327-332.
16. Prondzinsky R, Lemm H, Swyter M, et al. Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK Trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med, 2010, 38(1): 152-160.
17. Chang SN, Hwang JJ, Chen YS, et al. Clinical experience with intra-aortic balloon counterpulsation over 10 years: a retrospective cohort study of 459 patients. Resuscitation, 2008, 77(3): 316-324.
18. Gill BS, Nevillehlkhan AM, Jr CC, et al. Delayed institution of extracorporeal membrane oxygenation is associated with increased mortality rate and prolonged hospital stay. J Pediatr Surg, 2002, 37(1): 7-10.
19. Madershahian N, Wippermann J, Liakopoulos O, et al. The acute effect of IABP-induced pulsatility on coronary vascular resistance and graft flow in critical ill patients during ECMO. J Cardiovasc Surg, 2011, 52(3): 411-418.
20. Gao ZW, Huang YZ, Zhao HM, et al. Impact of intra-aortic balloon counterpulsation on prognosis of patients with acute myocardial infarction: A meta-analysis. Acta Cardiologica Sinica, 2017, 33(6): 567-577.
21. Sjauw KD, Engstrom AE, Vis MM, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J, 2009, 30(4): 459-468.
22. Ye L, Zheng M, Chen Q, et al. Effects of intra-aortic balloon counterpulsation pump on mortality of acute myocardial infarction. PLoS One, 2014, 9(9): e108-e356.
23. Ma P, Zhang Z, Song T, et al. Combining ECMO with IABP for the treatment of critically iii adult heart failure patients. Heart Lung Circ, 2014, 23(4): 363-368.
24. Schroeter T, Vollroth M, Hobartner M, et al. Influence of ECMO and IABP on coronary blood flow. Valuable combination or waste of resources? Med Klin Intensivmed Notfmed, 2015, 110(3): 210-216.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

體外膜肺氧合聯合主動脈內球囊反搏在心臟術后的應用

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