[Extracorporeal cardiopulmonary resuscitation in adult patients with cardiac arrest].
OBJECTIVE
To review the experience of extracorporeal cardiopulmonary resuscitation (E-CPR) for cardiac arrest in adults.


METHODS
From July 2005 to July 2009, extracorporeal life-support (ECLS) was performed for 10-15 minutes failed in CPR in 11 patients (male 7, female 4, age 24-71 years) with cardiac arrest. In 7 patients after cardiac operation, regular cardiopulmonary bypass was urgently established through re-opening of sternotomy incision, followed by extracorporeal membrane oxygenation (ECMO) for continuous support. In other 4 patients, ECMO implantation was directly performed through the femoral vessels during the CPR.


RESULTS
With E-CPR support, although the average CPR duration prolonged to (51+/-14) minutes (30-90 minutes), successful resuscitation was achieved in 10 patients with restoration of spontaneous heart beat. Median support duration of ECMO was 126 hours, ranged from 2 to 223 hours. Six patients could be successfully weaned from ECMO. However, the final discharge rate was 36.4% (4/11). Additional intra-aortic balloon pump was used in 2 patients, with 1 patient survived. Continuous renal replacement therapy (CRRT) was necessary in 3 patients because of acute renal failure.


CONCLUSIONS
The use of E-CPR can rescue some adult patients who fail to survive with conventional in-hospital CPR. Further studies are warranted to evaluate in order to better define patients who may benefit from E-CPR.
Luo
Xin-jin
XJ
Department of Cardiovascular Surgery, Fuwai Hospital, Beijing 100037, China. luo_xinjin@hotmail.com
Wang
Wei
W
Sun
Han-song
HS
Xu
Jian-ping
JP
Hu
Sheng-shou
SS
Long
Cun
C
Song
Yun-hu
YH
Hei
Fei-long
FL
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005112:Extracorporeal Circulation; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome