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Emergency resuscitation using portable extracorporeal membrane oxygenation
W P Dembitsky1, R J Moreno-Cabral, R M Adamson
1Sharp Memorial Hospital, San Diego, CA 92123.
The Annals of Thoracic Surgery
|January 1, 1993
Summary
Emergent cardiopulmonary bypass (CPB) can improve survival for cardiac arrest patients with severe circulatory issues. Early CPB support, even when delayed, offers the best survival benefits for selected patients.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care
Background:
- Manual cardiopulmonary resuscitation (CPR) is the standard for cardiac arrest.
- Emerging evidence suggests portable cardiopulmonary bypass (CPB) improves survival in extreme circulatory decompensation.
- Early CPB institution offers survival advantages in selected cardiac arrest patients.
Purpose of the Study:
- To evaluate the benefits of emergent cardiopulmonary bypass for cardiac arrest patients.
- To highlight the feasibility of using portable CPB in emergency settings.
- To underscore the role of CPB as a bridge to definitive therapy.
Main Methods:
- Implementation of an in-house team trained for emergent CPB preparation and management.
- Utilizing existing hospital infrastructure for open-heart surgery programs.
- Application of portable CPB units for temporary circulatory support.
Main Results:
- Accumulated evidence indicates enhanced survival with emergent CPB support.
- Long-term survival is achievable even with delayed CPB application.
- Early CPB in selected patients provides the greatest survival advantage.
Conclusions:
- Emergent cardiopulmonary bypass is a viable and effective treatment for selected cardiac arrest patients.
- Hospital infrastructure for CPB is widely available.
- Advancements in CPB technology suggest increased future application and prolonged support.