Home > List of Issue > Table of Contents > Abstract
![]() |
![]() |
|||||
Select Language in Japanese < > in English |
|
ArticleTitle | Measurement of End-tidal Carbon Dioxide in Patients with Cardiogenic Shock Treated Using a Percutaneous Cardiopulmonary Assist System |
AuthorList | Keiji Tanaka1, Naoki Sato1, Takeshi Yamamoto1, Koichi Akutsu1, Masahiro Fujii1 and Teruo Takano2 |
Affiliation | 1Division of Intensive and Coronary Care Unit, Nippon Medical School 2First Department of Internal Medicine, Nippon Medical School |
Language | EN |
Volume | 71 |
Issue | 3 |
Year | 2004 |
Page | 160-166 |
Received | November 4, 2003 |
Accepted | December 16, 2003 |
Keywords | end-tidal carbon dioxide (ET-CO2), percutaneous cardiopulmonary assist system (PCPS), cardiogenic shock |
Abstract | We have reported that percutaneous cardiopulmonary assist systems (PCPS) are effective in treating life-threatening cardiogenic shock that is intractable to treatment with intraaortic balloon pumping (IABP). However, there are few clinical indices that can be used to evaluate the effectiveness of PCPS. End-tidal carbon dioxide (ET-CO2) content reflects pulmonary blood flow. We monitored ET-CO2 continuously and determined whether we could use it as a new index to evaluate the effectiveness of PCPS. Seventeen patients with cardiogenic shock were intubated and evaluated by ET-CO2 monitoring during PCPS. The etiology of shock included acute myocardial infarction (n=10), acute myocarditis (n=2), recent coronary artery bypass graft (n=1), cardiac rupture (n=1), hypertrophic obstructive cardiomyopathy complicated by ventricular fibrillation (n=1), left atrial myxoma (n=1) and artificial valve malfunction (n=1). PCPS was extremely effective in 10 of 17 patients (58.8%), and they recovered from the cardiogenic shock. The remaining 7 patients did not recover from shock, and died during PCPS. Six of ten patients who recovered from shock were successfully weaned from PCPS and 4 patients had good long-term survival. In the cases where PCPS was effective, the ET-CO2 measured soon after the beginning of PCPS was significantly higher than in the cases in which PCPS was ineffective. Furthermore, the ET-CO2 content increased gradually with the improvement in hemodynamics. In contrast, ET-CO2 content remained low if PCPS was not effective. The ET-CO2 represents a useful predictor of survival or death and is also a good index for weaning in patients treated with PCPS. |
Correspondence to | Keiji Tanaka, MD, Director of Division of Intensive and Coronary Care Unit, Nippon Medical School, 1-1-5 Sendagi, Bunnkyo-ku, Tokyo 113-8603, Japan k-tanaka@nms.ac.jp |
Copyright © The Medical Association of Nippon Medical School