Percutaneous Cardiopulmonary Support：PCPS

Abstract

Percutaneous cardiopulmonary support（PCPS）, usually femoral vein to femoral artery cannulation with an extracorporeal membrane oxygenator and retrograde femoral artery bypass, retrieves de-oxygenated blood from the venous system and reinfuses the oxygenated blood into the arterial system. The common indications for administrating PCPS are acute refractory cardiogenic shock and cardiac arrest. According to the Extracorporeal Life Support Organization registry, > 15,000 adult patients have been supported with PCPS with an almost 40% survival rate to hospital discharge. PCPS provides greater hemodynamic support with high cardiac flow（3-7 L/min）. While PCPS can unload the central veins, right atrium, and right ventricle, it does not intrinsically unload the left ventricle, particularly when contractile function is severely compromised. There are several absolute contraindications, such as irrecoverable condition（neurologic injury, irreversible organ dysfunction）, unwitnessed asystole, and goals of care not in keeping with temporary mechanical support. Major complications following the use of PCPS are bleeding, thrombosis, and limb ischemia. Guidelines recommend that decisions regarding PCPS candidacy and subsequent management be made via a multi-disciplinary, team-based approach. We need to have a better understanding of PCPS systems and proper patient selection when we use this device.