Emergent Application of Extracorporeal Membrane Oxygenation in Patients Unresponsive to Cardiopulmonary Resuscitation
Journal
中華民國急救加護醫學會雜誌
Journal Volume
12
Journal Issue
2
Pages
55-62
Date Issued
2001
Author(s)
Abstract
Background: We attempted to identify the effect of extracorporeal membrane oxygenation (ECMO) in patients unresponsive to emergent cardiopulmonary resuscitation (CPR). Materials and Methods: Between January 1995 and January 2000, 35 unresponsive to conventional CPR patients were rescued by ECMO in our institute. The indication for emergent application of ECMO was the inability to resume a spontaneous heart beat or circulation after 10-min closed chest external cardiac massage and/or injection of more than 5 mg of epinephrine. Femoral venoarterial perfusion was achieved in all patients using a centrifugal pump, heparin-bonded cannulas, and a hollow-fiber oxygenator. Clinical date of these patients are reviewed. Results: The average age was 49.6± 12.4 years. Underlying disease leading to ECMO support included acute myocardial infarction ^(16), dilated cardiomyopathy ^(8), pulmonary embolism ^(4), prosthetic valve thrombosis ^(3), acute myocarditis ^(3), and acute rejection of a transplanted heart ^(1). ECMO allowed additional therapeutic intervention in 16 patients (45.7%). Weaning from ECMO was successful in 16 patients (45.7%); 7 patients (20%) survived and were discharged. Five of the 7 patients who survived had major therapeutic intervention after ECMO support. Conclusions: Patients with a surgically correctable or reversible disease were more likely to survive. Appropriate patient selection and early application of ECMO may lead to improved survival.
SDGs
Type
journal article