title: Extracorporeal membrane oxygenation to support prolonged conventional cardiopulmonary resuscitation in adults with cardiac arrest from acute myocardial infarction at a very low-volume centre.
abstract: We aimed to analyse the outcomes of the deployment of extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation (E-CPR) 11 times for acute myocardial infarction (AMI) in 10 adult patients at a very low-volume (VLV) centre, where perfusionists or surgeons are not always available. We conducted a three-year retrospective chart review. E-CPR was performed 13 times in 12 adult patients who had cardiac arrest events and who underwent conventional CPR for longer than 10 min. We excluded other aetiologies that led to E-CPR. All 11 selected episodes of E-CPR were diagnosed as AMI. Seven patients (63.6%) were successfully weaned off extracorporeal membrane oxygenation (ECMO). Four patients survived to discharge without neurological deficits or other postE-CPR complications (36.3%). Seven patients died after E-CPR, and with one patient, there was no return of spontaneous beating during E-CPR (0.9%). Three patients died of unstable haemodynamics despite revascularisation of the coronary circulation. Three patients were successfully weaned off ECMO; however, they died subsequently of multiple organ dysfunction, unstable haemodynamic changes and septic shock from nosocomial infections, respectively. The outcome of E-CPR in adults with AMI was compared with previous studies at high-volume centres. Mortality or morbidity rates are not higher at a VLV centre.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Province of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Yi Tso
authors.initials: YT
authors.lastname: Cheng
authors.forename: Jui Chi
authors.initials: JC
authors.lastname: Chang
authors.forename: Sheng Feng
authors.initials: SF
authors.lastname: Chao
authors.forename: Bee Song
authors.initials: BS
authors.lastname: Chang
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000401:mortality; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome