Percutaneous cardiopulmonary support in cardiac arrest.
Of 11 patients who underwent emergency resuscitation from cardiac arrest using a system of percutaneous cardiopulmonary support (CPS), two (18%) were long-term survivors. Percutaneous cardiopulmonary support was instituted without complication in all patients, with flows ranging from 1.8 to 5.5 L/min; the average duration of support was 304.3 min. All four patients who underwent emergency surgery (two coronary revascularization, one mitral valve revascularization, one mitral valve replacement with coronary revascularization, and one primary left ventricular assist device insertion) died. One patient died while on CPS secondary to irreversible ventricular arrhythmias after a successful percutaneous transluminal coronary angioplasty (PTCA). Six patients were weaned from the support system, three of whom had undergone PTCA while on CPS. The two survivors were the youngest patients (33 and 24 years). One of them had severe hypothyroidism as the cause of cardiac arrest, and the second was a hypothermia patient who was in ventricular fibrillation for 2 hr before establishing CPS. In comparing survivors (two) to nonsurvivors (nine), a significant difference (p = 0.034) in age was found, with survivors being younger. There was also a difference in incidence of atherosclerotic cardiovascular disease (p = 0.018), with survivors having none. There was no difference in the time to CPS (p = 0.905) or time on CPS (p = 0.156). Cardiopulmonary support can be instituted, resulting in excellent stabilization in patients with cardiac arrest. Survivors tended to be young and not have atherosclerotic cardiovascular disease (ASCVD) as their primary diagnosis. Neither length of cardiac arrest before CPS nor time on support correlated with a poor outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
Sugimoto
J T
JT
Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska.
Baird
E
E
Bruner
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001243:Assisted Circulation / Q000295:instrumentation*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015996:Survival Rate