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Emergency Cardio-Pulmonary Bypass in cardiac arrest: seventeen years of experience
Resuscitation, 07/17/2012
Wallmuller C et al. – Emergency cardiopulmonary bypass (E–CPB) for cardiac arrest is feasible and safe. In this seemingly desperate patient population after prolonged cardiac arrest, the authors observed a high survival rate of 15%. E–CPB is a meaningful treatment option, which should be considered more often and earlier.
Methods- Clinical presentation, time intervals, diagnosis and outcome of all patients who received E–CPB at an emergency department of a tertiary care university hospital were evaluated.
- Patient charts were reviewed regarding cardiac arrest variables and treatment data of all patients from 1993 to 2010.
- E–CPB was performed in 55 patients.
- Of all patients, 33(60%) were male and the median age was 32years(IQR 24–44).
- In all cases cardiac arrest was witnessed.
- The first recorded ECG rhythm showed pulsless electric activity in 23(42%), ventricular fibrillation in 21(38%) and asystole in 11(20%) patients.
- Cardiac arrest occurred out–of–hospital in 33(60%) patients.
- The median duration of CPR before performing E–CPB was 86minutes(IQR 69–121).
- The median ‘cannulation’–time was 33minutes(IQR 21–45) and the duration on bypass was 311minutes(IQR 161–953).
- Cardiac causes of arrest was found in 19(35%) patients.
- Eight patients (15%) survived to 6 months with good neurological outcome.
