Arévalo ES, Bello CJA, Escobedo FD, Durán ÓA, Rodríguez RM, Soto ÁLB

Language: Spanish
References: 9
Page: 97-101
PDF size: 137.72 Kb.

ABSTRACT

Objective: To report the incidence of massive transfusion in postcardiotomy shock in patients supported with ventricular-assist devices (VAD).
Design: Retrospective study. Setting: Surgical ICU (SICU) of a tertiary care hospital of Monterrey, Mexico.
Patients: All the patients with VAD admitted to the SICU during five years were enrolled.
Interventions: None.
Measurements and main results: Eight VAD patients (mean age 47.1 ± 10.3 yrs) were evaluated. VAD supportwas 5.37 ±, 2.38 days, ICU stay 9.75 ± 2.38 days and mortality rate 75%. Two patients required massive transfusion and six were supported with VAD plus intraaortic ballon counterpulsation. Multiple organ failure (SOFA score) was observed in seven patients: one patient had 6 failures, three 5, two 2, one 4 and one 1; coagulation disorders was the main failure.
Conclusion: The morbility and mortality rate are very high in VAD patients with shock postcardiotomy.

REFERENCES

1. Frazier OH. New technologies in the treatment of severe cardiac failure: The Texas Heart Institute experience. Ann Thorac Surg 1995;59:S31-S38.

2. Müller J, Wallukat G, Weng YG et al. Weaning from mechanical cardiac support in patients with idiopathic dilated cardiac support in patients with idiopathic dilated cardiomyopathy. Circulation 1997;96:542-549.

3. Dipla K, Mattiello JA, Jeevanandam V, Houser SR, Margulies KB. Myocyte recovery after mechanical circulatory support in humans with end-stage heart failure. Circulation 1998;97:2316-2322.

4. Pennington DG, McBride LR, Kanter KR, Swartz MT, Lagunoff D et al. Effect of perioperative myocardial infarction on survival of postcardiotomy patients supportted with ventricular-assist devices. Circulation 1988;78(Suppl III)110-115.

5. Guyton RA, Schonberger JPAM, Everts PAM, Jett K, Gray LA et al. Postcardiotomy shock: clinical evaluation of the BVS 5000 biventricular support system. Ann Thorac Surg 1993;56:346-356.

6. Brister SJ, Shragge BW. Mechanical assistance of the failing heart. Chapter In principles of critical care. Jesse B Hall. New York 1992;28:366-372.

7. Deisseroth AB, Wallerstein RO. Grupos sanguíneos, tipificación de tejidos y transfusiones de productos de la sangre.In Kelley WN, editor. Medicina Interna. Editorial Médica Panamericana 1992:1331-1336.

8. Harrigan C, Lucas CE, Ledgerwood AM, Walz DA, Mammen EF. Serial changes in primary hemostasis after massive transfusion. Surgery 1985; 98(4): 836-44.

9. Vincent JL, De Mendonca A, Cantraine F, Moreno R,Takala J et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study. Crit Care Med 1998; 26 11: 1793-1800.