Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation

Yih Sharng Chen, Anne Chao, Hsi Yu Yu, Wen Je Ko, I. Hui Wu, Robert Jen Chen Chen, Shu Chien Huang, Fang Yue Lin, Shoei Shan Wang

Research output: Contribution to journalArticle

248 Citations (Scopus)

Abstract

OBJECTIVES: We conducted this study to determine the result of prolonged cardiopulmonary resuscitation (CPR) with extracorporeal membrane oxygenation (ECMO) and the predictive factors for hospital discharge and ECMO weaning. BACKGROUND: Prolonged CPR carries considerable associated mortality and morbidity. As yet, ECMO for prolonged CPR has no definite results. Only small groups of patients and no detailed analysis have been reported. METHODS: Candidates for ECMO resuscitation were patients in cardiac arrest receiving CPR >10 min without return of spontaneous circulation and no absolute contraindication. Venoarterial ECMO was set up during CPR. We reviewed the data of 57 prolonged CPR patients who received ECMO during CPR over a six-year period. RESULTS: The mean duration of CPR was 47.6 ± 13.4 min and that of ECMO was 96.1 ± 87.9 h. The rate of weaning was 66.7%, and the survival rate was 31.6%. Multiple-organ failure was the major reason for mortality, despite successful weaning. Among survivors, long-term follow-up revealed 88.9% survival, and only 5.6% had a severe neurologic deficit. The results indicate that a shorter CPR duration, postcardiotomy arrest, myocardial indicators, a hepatic indicator, and lactic acid are significantly correlated with both weaning and survival, whereas late damage (level on the third or seventh day of reperfusion) rather than initial damage (level on the first day) was more predictive of the results. CONCLUSIONS: Prolonged CPR rescue by ECMO provides an acceptable survival rate and outcome in survivors. Our results of the selected cases encourage further investigations of the wider application of ECMO in CPR.

Original languageEnglish
Pages (from-to)197-203
Number of pages7
JournalJournal of the American College of Cardiology
Volume41
Issue number2
DOIs
Publication statusPublished - Jan 15 2003
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Cardiopulmonary Resuscitation
Heart Arrest
Resuscitation
Weaning
Survivors
Survival Rate
Survival
Multiple Organ Failure
Mortality
Neurologic Manifestations
Reperfusion
Lactic Acid

ASJC Scopus subject areas

  • Nursing(all)

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Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation. / Chen, Yih Sharng; Chao, Anne; Yu, Hsi Yu; Ko, Wen Je; Wu, I. Hui; Chen, Robert Jen Chen; Huang, Shu Chien; Lin, Fang Yue; Wang, Shoei Shan.

In: Journal of the American College of Cardiology, Vol. 41, No. 2, 15.01.2003, p. 197-203.

Research output: Contribution to journalArticle

Chen, Yih Sharng ; Chao, Anne ; Yu, Hsi Yu ; Ko, Wen Je ; Wu, I. Hui ; Chen, Robert Jen Chen ; Huang, Shu Chien ; Lin, Fang Yue ; Wang, Shoei Shan. / Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation. In: Journal of the American College of Cardiology. 2003 ; Vol. 41, No. 2. pp. 197-203.
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AU - Wu, I. Hui

AU - Chen, Robert Jen Chen

AU - Huang, Shu Chien

AU - Lin, Fang Yue

AU - Wang, Shoei Shan

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AB - OBJECTIVES: We conducted this study to determine the result of prolonged cardiopulmonary resuscitation (CPR) with extracorporeal membrane oxygenation (ECMO) and the predictive factors for hospital discharge and ECMO weaning. BACKGROUND: Prolonged CPR carries considerable associated mortality and morbidity. As yet, ECMO for prolonged CPR has no definite results. Only small groups of patients and no detailed analysis have been reported. METHODS: Candidates for ECMO resuscitation were patients in cardiac arrest receiving CPR >10 min without return of spontaneous circulation and no absolute contraindication. Venoarterial ECMO was set up during CPR. We reviewed the data of 57 prolonged CPR patients who received ECMO during CPR over a six-year period. RESULTS: The mean duration of CPR was 47.6 ± 13.4 min and that of ECMO was 96.1 ± 87.9 h. The rate of weaning was 66.7%, and the survival rate was 31.6%. Multiple-organ failure was the major reason for mortality, despite successful weaning. Among survivors, long-term follow-up revealed 88.9% survival, and only 5.6% had a severe neurologic deficit. The results indicate that a shorter CPR duration, postcardiotomy arrest, myocardial indicators, a hepatic indicator, and lactic acid are significantly correlated with both weaning and survival, whereas late damage (level on the third or seventh day of reperfusion) rather than initial damage (level on the first day) was more predictive of the results. CONCLUSIONS: Prolonged CPR rescue by ECMO provides an acceptable survival rate and outcome in survivors. Our results of the selected cases encourage further investigations of the wider application of ECMO in CPR.

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