title: Successful extracorporeal life support in cardiac arrest with recurrent ventricular fibrillation unresponsive to standard cardiopulmonary resuscitation.
abstract: Extracorporeal life support has been used as an extension of conventional cardiopulmonary resuscitation (CPR). However, the appropriate indications for extracorporeal CPR (ECPR) including the duration of CPR are unknown. We present a case of a male, 37-year-old out-of-hospital cardiac arrest patient who received prolonged CPR followed by ECPR. Despite advanced cardiac life support, he did not regain a sustained spontaneous circulation and had recurrent ventricular fibrillation (VF) during the prolonged CPR. VF was unresponsive to CPR, defibrillation, adrenaline (epinephrine), and antiarrhythmics. The CPR time before ECPR was approximately 2h. During extracorporeal life support, the VF did not recur and percutaneous coronary angioplasty was achieved. Ultimately, the patient was discharged without neurological complications. Although cardiac arrest occurred out-of-hospital and CPR was performed for a long time, a patient might be a candidate for ECPR if perfusing rhythms are restored transiently but not successfully maintained due to recurrent VF. ECPR may be used for VF unresponsive to standard CPR techniques.
authors.affiliation: Department of Thorasic and Cardiovascular Surgery, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Jae-Seung
authors.initials: JS
authors.lastname: Shin
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Gap-Su
authors.initials: GS
authors.lastname: Han
authors.forename: Won-Min
authors.initials: WM
authors.lastname: Jo
authors.forename: Sung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Yun-Sik
authors.initials: YS
authors.lastname: Hong
mesh_terms: D000328:Adult; D022561:Advanced Cardiac Life Support; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000628:therapy*; D006440:Hemofiltration; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000628:therapy*