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Role and Prognosis of Extracorporeal Life Support in Patients Who Develop Cardiac Arrest during or after Office-Based Cosmetic Surgery

권성순, 박병원, 이민호, 방덕원, 현민수, Chang Won-Ho, 오홍철, 박영우,
소속 상세정보
권성순 ( Kwon Seong-Soon ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
박병원 ( Park Byoung-Won ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
이민호 ( Lee Min-Ho ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
방덕원 ( Bang Duk-Won ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
현민수 ( Hyon Min-Su ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
 ( Chang Won-Ho ) - Soonchunhyang University Seoul Hospital Department of Chest Surgery
오홍철 ( Oh Hong-Chul ) - Soonchunhyang University Seoul Hospital Department of Chest Surgery
박영우 ( Park Young-Woo ) - Soonchunhyang University Seoul Hospital Department of Chest Surgery

Abstract


Background: Cardiac arrest during or after office-based cosmetic surgery is rare, and little is known about its prognosis. We assessed the clinical outcomes of patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics.

Methods: Between May 2009 and May 2016, 32 patients who developed cardiac arrest during or after treatment at cosmetic surgery clinics were consecutively enrolled. We compared clinical outcomes, including complications, between survivors (n=19) and non-survivors (n=13) and attempted to determine the prognostic factors of mortality.

Results: All 32 of the patients were female, with a mean age of 30.40±11.87 years. Of the 32 patients, 13 (41%) died. Extracorporeal life support (ECLS) was applied in a greater percentage of non-survivors than survivors (92.3% vs. 47.4%, respectively; p=0.009). The mean duration of in-hospital cardiopulmonary resuscitation (CPR) was longer for the non-survivors than the survivors (31.55±33 minutes vs. 7.59±9.07 minutes, respectively; p=0.01). The mean Acute Physiology and Chronic Health Evaluation score was also higher among non-survivors than survivors (23.85±6.68 vs. 16.79±7.44, respectively; p=0.01). No predictor of death was identified in the patients for whom ECLS was applied. Of the 19 survivors, 10 (52.6%) had hypoxic brain damage, and 1 (5.3%) had permanent lower leg ischemia. Logistic regression analyses revealed that the estimated glomerular filtration rate was a predictor of mortality.

Conclusion: Patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics experienced poor prognoses, even though ECLS was applied in most cases. The survivors suffered serious complications. Careful monitoring of subjects and active CPR (when necessary) in cosmetic surgery clinics may be essential.

키워드

Plastic surgery; Cardiac arrest; Extracorporeal circulation

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