Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation
Journal
Journal of the American College of Cardiology
Journal Volume
41
Journal Issue
2
Pages
197-203
Date Issued
2003
Author(s)
Ko W.-J.
Chen R.J.-C.
Lin F.-Y.
Abstract
OBJECTIVES: We conducted this study to determine the result of prolonged cardiopulmonary resuscitation (CPR) with extracorporeal membrane oxygenation (ECMO) and the predictive factors for hospital discharge and ECMO weaning. BACKGROUND: Prolonged CPR carries considerable associated mortality and morbidity. As yet, ECMO for prolonged CPR has no definite results. Only small groups of patients and no detailed analysis have been reported. METHODS: Candidates for ECMO resuscitation were patients in cardiac arrest receiving CPR >10 min without return of spontaneous circulation and no absolute contraindication. Venoarterial ECMO was set up during CPR. We reviewed the data of 57 prolonged CPR patients who received ECMO during CPR over a six-year period. RESULTS: The mean duration of CPR was 47.6 ± 13.4 min and that of ECMO was 96.1 ± 87.9 h. The rate of weaning was 66.7%, and the survival rate was 31.6%. Multiple-organ failure was the major reason for mortality, despite successful weaning. Among survivors, long-term follow-up revealed 88.9% survival, and only 5.6% had a severe neurologic deficit. The results indicate that a shorter CPR duration, postcardiotomy arrest, myocardial indicators, a hepatic indicator, and lactic acid are significantly correlated with both weaning and survival, whereas late damage (level on the third or seventh day of reperfusion) rather than initial damage (level on the first day) was more predictive of the results. CONCLUSIONS: Prolonged CPR rescue by ECMO provides an acceptable survival rate and outcome in survivors. Our results of the selected cases encourage further investigations of the wider application of ECMO in CPR. ? 2003 by the American College of Cardiology Foundation.
SDGs
Other Subjects
lactic acid; adult; aged; article; extracorporeal oxygenation; female; heart arrest; heart muscle reperfusion; hospital discharge; human; major clinical study; male; morbidity; mortality; multiple organ failure; neurologic disease; priority journal; resuscitation; survival rate; treatment outcome; weaning; Adult; Aged; Cardiopulmonary Resuscitation; Extracorporeal Membrane Oxygenation; Female; Heart Arrest; Humans; Male; Middle Aged; Risk Factors; Survival Rate; Treatment Outcome
Type
journal article