Early whole body CT combined with coronary angiography for treatment guidance in patients with extracorporeal cardiopulmonary resuscitation
10.3760/cma.j.issn.1671-0282.2022.12.005
- VernacularTitle:早期全身CT联合冠状动脉造影术在体外心肺复苏中的应用
- Author:
Yi ZHU
1
;
Xufeng CHEN
;
Wei LI
;
Zhongman ZHANG
;
Yong MEI
;
Jinru LV
;
Deliang HU
;
Gang ZHANG
;
Feng SUN
;
Huazhong ZHANG
;
Di AN
;
Yue ZOU
;
Tao DING
;
Shuang LOU
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- Keywords:
extracorporeal cardiopulmonary resuscitation;
whole body computed tomography;
coronary angiography;
cardiopulmonary resuscitation-related complications
- From:
Chinese Journal of Emergency Medicine
2022;31(12):1603-1607
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety of early whole body computed tomography (WBCT) combined with coronary angiography (CAG) in patients with extracorporeal cardiopulmonary resuscitation (ECPR) and its application value in the diagnosis of cardiac arrest and complications of cardiopulmonary resuscitation (CPR).Methods:This was a retrospective study. Patients who underwent ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2021 were enrolled in this research. Patients younger than 18 years or with incomplete clinical data were excluded. The results of WBCT and CAG examinations after ECPR were collected.Results:A total of 89 patients with ECPR, aged (47±17) years, were enrolled in the study, all underwent WBCT examination, and no adverse events such as ECMO and tracheal tube shedding occurred. WBCT found 7 cases of pulmonary embolism, 3 cases of aortic dissection and 2 cases of cerebral hemorrhage. WBCT identified CPR-related complications in 42 cases, including rib fractures ( n=20), pneumothorax ( n=5), mediastinal emphysema ( n=5), subcutaneous emphysema ( n=6), and hematoma or swelling at puncture site ( n=6). Fifty-five patients underwent CAG examination, the most common culprit vessels were the left anterior descending branch disease (58.2%) followed by the left circumflex branch disease (27.3%), the right coronary artery disease (21.8%) and left main artery disease (12.7%). Conclusions:Early WBCT and CAG examinations are of great significance and safety for the guidance of treatment in ECPR patients.
