Cardiac Arrest in the Cardiac Catheterization Laboratory
| Autor: | Hanan Alsakka, Matthew C. Kern, Karl B. Kern, Chiu Hsieh Hsu, Huu Tam Truong, Kyoung-Chul Cha, Kapildeo Lotun, Prashant Rao, Mathias Zuercher, Renan Gianotto-Oliveira, Tyler Bien, Nicole Smith, Shaun Chatelain |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Cath lab business.industry medicine.medical_treatment Percutaneous coronary intervention 030204 cardiovascular system & hematology Return of spontaneous circulation medicine.disease 03 medical and health sciences 0302 clinical medicine Coronary occlusion Internal medicine Ventricular assist device Ventricular fibrillation medicine Cardiology 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Impella Cardiac catheterization |
| Zdroj: | JACC: Cardiovascular Interventions. 12:1840-1849 |
| ISSN: | 1936-8798 |
| Popis: | Objectives The aim of this study was to evaluate the optimal treatment approach for cardiac arrest (CA) occurring in the cardiac catheterization laboratory. Background CA can occur in the cath lab during high-risk percutaneous coronary intervention. While attempting to correct the precipitating cause of CA, several options are available to maintain vital organ perfusion. These include manual chest compressions, mechanical chest compressions, or a percutaneous left ventricular assist device. Methods Eighty swine (58 ± 10 kg) were studied. The left main or proximal left anterior descending artery was occluded. Ventricular fibrillation (VFCA) was induced and circulatory support was provided with 1 of 4 techniques: either manual chest compressions (frequently interrupted), mechanical chest compressions with a piston device (LUCAS-2), an Impella 2.5 L percutaneously placed LVAD, or the combination of mechanical chest compressions and the percutaneous left ventricular assist device. The study protocol included 12 min of left main coronary occlusion, reperfusion, with defibrillation attempted after 15 min of VFCA. Primary outcome was favorable neurological function (CPC 1 or 2) at 24 h, while secondary outcomes included return of spontaneous circulation and hemodynamics. Results Manual chest compressions provided fewer neurologically intact surviving animals than the combination of a mechanical chest compressor and a percutaneous LVAD device (0% vs. 56%; p Conclusions Combining 2 mechanical devices provided superior 24-h survival with favorable neurological recovery compared with manual compressions during moderate duration VFCA associated with an acute coronary occlusion in the animal catheterization laboratory. |
| Databáze: | OpenAIRE |
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