Experience and directions using cardiopulmonary support in fifty-three consecutive cases

Emergency cardiopulmonary support (CPS) was instituted in 53 consecutive patients for acute life threatening pathologies. Indications for CPS deployment were: cardiac arrest, 60% (n = 32); cardiogenic shock, 20.4% (n = 11), supported angioplasty, 13% (n = 7); and adult respiratory distress syndrome, 5.6% (n = 3). Cardiopulmonary support was successfully deployed in 51 of the 53 patients (96%), resulting in a mean blood pressure greater than or equal to 60 mmHg, CO greater than or equal to 3-5 L/min, and partial pressure of oxygen greater than or equal to 100 mmHg, with venous oxygen saturation greater than or equal to 60%. The average time from arrest to CPS deployment was 40 minutes. Seventy-nine major cardiovascular procedures were done in these 51 patients (average, 1.5/patient). The duration of support ranged from 1 to 75 hrs (mean, 16.1 hrs). Twenty-seven patients (53%) were weaned, 13 successfully (32%), with 11 (85%) surviving greater than 24 hrs, and six (46%), greater than 30 days. The other 24 patients (47%) were transferred to other treatment modalities, including cardiac surgery and bridge-to-transplant ventricular assist devices. Four of these patients died (17%), whereas 20 (83%) survived. Of these survivors, 19 (95%) survived greater than 24 hrs, whereas 11 (55%) survived greater than 30 days. The overall survival using the CPS system is 59% short-term (greater than 24 hrs.), and 33% long-term (greater than 30 days). In conclusion, the CPS system is a potent and effective resuscitative tool. It requires transfer to other treatment modalities for survival in most cases.