Informação da revista
Vol. 41. Núm. 2.
Páginas 181-182 (Fevereiro 2022)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 41. Núm. 2.
Páginas 181-182 (Fevereiro 2022)
Image in Cardiology
Open Access
Arterial waveform during extracorporeal cardiopulmonary resuscitation
Curva de linha arterial durante ressuscitação cardiopulmonar
Visitas
2497
João João Mendesa,
Autor para correspondência
joao.mendes@cuf.pt

Corresponding author.
, Ruben Ramosb, Paulo Francoc, Pedro Poncec
a Intensive Care Department, Hospital CUF Tejo, Lisboa, Portugal
b Cardiology Department, Hospital CUF Tejo, Lisboa, Portugal
c Hemocircuitos, Lisboa, Portugal
Este item recebeu

Under a Creative Commons license
Informação do artigo
Texto Completo
Baixar PDF
Estatísticas
Figuras (1)
Texto Completo

Extracorporeal cardiopulmonary resuscitation (ECPR) is the implantation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in a patient experiencing a sudden and unexpected pulseless condition attributable to cessation of cardiac mechanical activity.

A 57-year-old male presented to our hospital with an acute coronary syndrome. A diagnostic coronary angiography was performed showing a critical lesion of the left main coronary artery, with severely compromised left ventricular systolic function. The patient was transferred to the intensive care unit awaiting coronary artery bypass grafting, and a right radial arterial line was put in place.

The patient complained of recurrent chest pain and rapidly evolved to cardiac arrest in pulseless electrical activity. The advanced cardiac life support protocol was started promptly, initially with manual compressions and then using an automatic chest compression system. Expeditiously the ECMO team cannulated and connected the patient to the ECMO machine. An emergent percutaneous coronary intervention (angioplasty and stent placement) of the left main coronary artery was performed. Arterial line waveform recordings were obtained during all stages of resuscitation (Figure 1).

Figure 1.

Electrocardiographic and arterial line waveforms during resuscitation. (a) Pulseless electrical activity cardiac arrest with an almost flat arterial waveform at 0-5 mmHg and start of manual compression generating a pulsatile blood flow with a low mean arterial pressure; (b) compressions using a chest compression system generating a pulsatile blood flow with a mean arterial pressure of 50 mmHg; (c) arterial line waveform showing an almost flat arterial wave form with a mean arterial pressure of 60 mmHg during initial venoarterial extracorporeal membrane oxygenation; (d) arterial line waveform showing recovery of pulsatile blood pressure with a pulse pressure of 10 mmHg after 5 min of venoarterial extracorporeal membrane oxygenation; (e) arterial line waveform showing full recovery of pulsatile blood pressure after percutaneous coronary intervention.

(0,05MB).

ECPR is on its way to transforming patient outcomes after cardiac arrest, and arterial waveform interpretation is essential in the technical management of VA-ECMO.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2021. Sociedade Portuguesa de Cardiologia
Idiomas
Revista Portuguesa de Cardiologia
Opções de artigo
Ferramentas
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.