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Table 2 Hemodynamic status of the patient on admission, before and after the initiation of PCPS, after the onset of complete atrioventricular block, and after ventricular pacing

From: A case of a giant cell myocarditis that developed massive left ventricular thrombus during percutaneous cardiopulmonary support

 

Admission

Before initiation of PCPS

Initiation of PCPS

Onset of complete AVB

After ventricular pacing

Respiratory support

Face mask, 5 L/min of oxygen

Face mask, 6 L/min of oxygen

APRV, FIO2 = 0.6, P high = 20 cm H2O, T high = 9.5 s, P low = 0 cm H2O, T low = 0.5 s

Same as on the left

APRV, FIO2 = 0.6, P high = 15 cm H2O, T high = 5.5 s, P low = 0 cm H2O, T low = 0.5 s

pH

7.531

7.532

7.449

7.272

7.554

SaO2 (%)

95.1

97.0

98.5

95.7

98.5

PaO2 (mmHg)

75.4

97.0

153.0

100.8

158.0

PaCO2 (mmHg)

25.5

28.1

34.8

62.5

27.3

EtCO2 (mmHg)

21

41

17

BE (mmol/L)

−0.2

1.7

−0.1

0.3

1.9

Lac (mmol/L)

1.2

1.3

1.12

1.03

1.28

ABP (mmHg)

110/55

112/42

97/41

70/40

136/37

PAP (mmHg)

37/18 (26)

28/11

19/10

60/20

18/13

PAWP (mmHg)

25

12

30

RAP (mmHg)

18

18

12

18

8

CO (L/min)

3.60

3.80

2.3

<<1.0

1.3

Output of PCPS (L/min)

3.0

3.0

3.5

The sum of PCPS blood flow and his own cardiac output (L/min)

3.60

3.80

5.3

3.0

4.8

Total gas flow of oxygenator (L/min)

1.0

1.0

4.0

SvO2 (%)

40

39.7

66

55

69

  1. The cardiogenic shock was improved by the PCPS support. After the onset of complete AV block, significant decrease of CO, pulmonary congestion, and increased PaCO2 were observed
  2. PCPS percutaneous cardiopulmonary support, AVB atrioventricular block, APRV airway pressure release ventilation, F I O 2 fraction of inspired oxygen, P high high continuous positive airway pressure, T high duration of P high, P low low continuous positive airway pressure, T low duration of P low, EtCO 2 end-tidal carbon dioxide tension, PaCO 2 arterial carbon dioxide tension, ABP arterial blood pressure, PAP pulmonary artery pressure, PAWP pulmonary artery wedge pressure, RAP right atrial pressure, CO cardiac output, SvO 2 mixed venous oxygenation saturation