Experience with an emergency resuscitation system.
The need for a portable extracorporeal support system that can be rapidly initiated for various types of cardiopulmonary failure is well known. The authors report on a system consisting of 3/8 inch tubing, a Sci-Med membrane oxygenator, Omnitherm heat exchanger, Biomedicus or Sarns centrifugal pump, portable battery, and oxygen tanks. The system is mounted on a cart for easy mobility and can be primed in 5-10 min. USCI, DLP, or Axiom cannulas can be inserted femorally. Over 30 months, 29 patients, aged 19-78 years, underwent extracorporeal membrane oxygenation (ECMO) support for cardiac arrest during catheterization (10 patients), shock secondary to acute myocardial infarction (MI) (10 patients), elective percutaneous transluminal coronary angioplasty (PTCA) support (four patients), postcardiotomy failure (four patients), and exposure hypothermia (one patient). Adequate support was achieved in all but one patient. Device flows ranged from 0.2 to 6.0 l/min. There were six survivors (elective PTCA support, three patients; cardiac arrest during catheterization, three patients). Complications included bleeding (15 patients), deep venous thrombosis (three patients), and pump failure (one patient). A portable ECMO system has been developed that allows rapid institution of circulatory support.
Raithel
S C
SC
Division of Cardiothoracic Surgery, St. Louis University School of Medicine, Missouri.
Swartz
M T
MT
Braun
P R
PR
Dake
S B
SB
Taub
J O
JO
Zambie
M A
MA
Miller
L W
LW
Deligonul
U
U
McBride
L R
LR
Pennington
D G
DG
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004630:Emergencies; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D012151:Resuscitation / Q000295:instrumentation*; D012770:Shock, Cardiogenic / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000628:therapy