Background: The percutaneous cardiopulmonary support system (PCPS) has been used for rescuing patients with severe cardiopulmonary failure. However, the indication for deployment and discontinuation of PCPS has not yet been established. We reviewed the results of PCPS to investigate factors which could predict successful weaning from PCPS.
Methods and Results: From April 2006 to March 2008, PCPS had been applied to 21 patients (11 men). There were 19 cardiac arrest cases - ischemic heart disease (11, 52.4 %), pulmonary thromboembolism (4, 19 %), valvular heart disease (2, 9.5 %), myocarditis (2, 9.5 %) and 2 cases of acute respiratory distress syndrome due to pneumonia. The product of PCPS used in our cases was Capiox emergent bypass system (Terumo, Japan). The mean age was 57.52 ± 17.5 years. The mean duration of cardiopulmonary resuscitation (CPR) before PCPS was 36.3 ± 26.2 minutes. An intraaortic balloon pump and continuous hemodiafiltration was used in the cases of 9 (42.9 %) and 7 (33.3 %) patients, respectively. The mean duration of PCPS was 97.89 ± 70.2 hours. Nine (42.9 %) patients could be weaned off (group A), while the remaining 12 patients (57.1 %) could not (group B). Among group A, 7 patients (33.3 %) were discharged from hospital. The CPR duration was shorter in group A than in group B (18 ± 13.3 vs. 50.4 ± 25.1 minutes, P = 0.006). PO2 of initial arterial blood gas analysis was higher in group A than in group B (115.5 ± 53.6 vs. 56.4 ± 22.8 mmHg, P = 0.011). The incidence of leukocytosis was lower in group A than in group B (10896 ± 3422 vs. 15975 ± 5791 per microliter, P = 0.022). In echocardiographic data, there was no difference between two groups in left ventricular ejection fraction (group A, 38 ± 18.8 vs. group B, 38 ± 19.3 %, P = 0.975). Only left atrial size of group B was larger than group A (P = 0.026). Conclusions: Understanding predictors for weaning off PCPS may help us to determine whether to initiate PCPS for achieving the restoration of spontaneous circulation, and facilitate the decision-making with regard to long-term circulatory support versus withdrawal of life support for hopeless cases.
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