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Cardiac arrest in the ECMO candidate.

D von Allmen1, F C Ryckman

  • 1Division of Pediatric Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229.

Journal of Pediatric Surgery
|February 1, 1991
PubMed
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Extracorporeal membrane oxygenation (ECMO) can be used for neonates experiencing cardiac arrest, though survival rates are lower than for respiratory failure. Survivors show good neurological function despite some brain lesions.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Critical Care

Background:

  • Extracorporeal membrane oxygenation (ECMO) is established for neonatal respiratory failure.
  • The efficacy and outcomes of ECMO in neonates with cardiac arrest are not well-documented.

Purpose of the Study:

  • To review the clinical course and outcomes of neonates undergoing ECMO after cardiac arrest.
  • To compare survival rates in this high-risk group to the general ECMO population.

Main Methods:

  • Retrospective review of 10 neonates who received ECMO post-cardiac arrest at Children's Hospital Medical Center.
  • Analysis of patient characteristics, ECMO course, and neurological outcomes.

Main Results:

  • 60% long-term survival in the cardiac arrest group, significantly lower than the 87% overall ECMO survival (P < .01).

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  • Nonsurvivors experienced progressive multisystem organ failure.
  • Three of six survivors had right-sided brain lesions on CT, but showed adequate neurological development.

    • Conclusions:

    • ECMO can be a viable resuscitation tool for neonatal cardiac arrest cases.
    • Despite risks, neurological function appears preserved in survivors, suggesting ECMO's role in this critical population.