Improved patient survival after cardiac arrest using a cardiopulmonary support system

Reichman, Robert T.; Joyo, Colin I.; Dembitsky, Walter P.; Griffith, Lee D.; Adamson, Robert; Daily, Pat O.; Overlie, Paul; Smith, Sidney C.; Jaski, Brian E.

doi:10.1016/0003-4975(90)90363-b

Cited by 118 publications

(28 citation statements)

References 12 publications

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“…It will be used electively in high-risk patients undergoing angioplasty , as discussed elsewhere in this symposium. Its use as a bridge to more sophisticated circulatory support devices is in the embryonic stages, but this use can be justified [13].…”

Section: Discussionmentioning

confidence: 99%

Emergency use of portable cardiopulmonary bypass

Overlie¹

1990

Cathet. Cardiovasc. Diagn.

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Section: Discussionmentioning

confidence: 99%

Emergency use of portable cardiopulmonary bypass

Overlie¹

1990

Cathet. Cardiovasc. Diagn.

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“…122,123 ECPR has been proposed as a rescue therapy in patients with cardiac arrest refractory to standard therapy. Case-control studies suggest that ECPR is associated with better outcomes compared with no ECPR in cardiac resuscitation systems of care with a low overall survival.…”

Section: Extracorporeal Cprmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

McCarthy¹,

Carr²,

Sasson³

et al. 2018

Circulation

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ABSTRACT:The American Heart Association previously recommended implementation of cardiac resuscitation systems of care that consist of interconnected community, emergency medical services, and hospital efforts to measure and improve the process of care and outcome for patients with cardiac arrest. In addition, the American Heart Association proposed a national process to develop and implement evidence-based guidelines for cardiac resuscitation systems of care. Significant experience has been gained with implementing these systems, and new evidence has accumulated. This update describes recent advances in the science of cardiac resuscitation systems and evidence of their effectiveness, as well as recent progress in dissemination and implementation throughout the United States. Emphasis is placed on evidence published since the original recommendations (ie, including and since 2010). Cardiac arrest is loss of mechanical activity of the heart confirmed by the absence of signs of circulation.1 Approximately 356 461 people are treated for out-of-hospital cardiac arrest (OHCA) annually in the United States.2 One third of cases occur without any prior recognized heart disease; half occur without any prodromal symptoms.3 Despite robust systems of care for patients with trauma and rapidly evolving systems of care for patients with ST-segment-elevation myocardial infarction (STEMI) and stroke, the majority of communities do not achieve optimal survival after OHCA because of large discrepancies in resuscitation-related processes of care.4-6 As a result, survival to hospital discharge varies significantly both across different regions and by presenting rhythm. 7,8 Survival increases significantly if the OHCA is quickly recognized and responded to with prompt activation of 9-1-1, bystander-initiated cardiopulmonary resuscitation (CPR), bystander and/or basic first responder application of an automated external defibrillator (AED) before arrival of other emergency medical services (EMS) providers on scene, advanced life support, and postresuscitation care. The American Heart Association (AHA) previously recommended implementation of cardiac resuscitation systems of care that consist of interconnected community, EMS, and hospital efforts to measure and improve the process and outcome of care for patients with cardiac arrest.10 Simultaneously, the AHA proposed a national process to develop and implement evidence-based guidelines for the implementation and measurement of such systems. The 2015 AHA guidelines for CPR and emergency cardiovascular care delved deeper into the elements of an effective system of care for both OHCA and in-hospital cardiac arrest.11 This update on OHCA resuscitation systems of care describes recent advances, evidence

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“…The clinical results in these studies, however, were variable, with survival rates of 3.4%-64% [1-7, 16, 17]. The presence of an anatomically correctable lesion is one of the major factors directly related to survival [1,2].…”

Section: Discussionmentioning

confidence: 98%

“…The use of the percutaneous cardiopulmonary bypass support system (PCPS) has been increasing in both cardiac and non-cardiac patients who suffer from cardiopulmonary collapse [1][2][3][4][5][6][7][8][9]. The clinical results of PCPS, The PCPS used in all patients was housed in a small mobile cart and has been described previously [10].…”

Section: Introductionmentioning

confidence: 99%

Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction

et al. 1996

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A total of 16 patients who developed severe cardiogenic shock were resuscitated with a percutaneous cardiopulmonary support system (PCPS). The etiology of shock was acute myocardial infarction (n = 7), or post-infarction left-ventricular (LV) free wall rupture (n = 9). After successful resuscitation with the PCPS, 15 patients underwent therapeutic interventions: closure of an LV rupture (n = 9), coronary artery bypass grafting (n = 4), percutaneous transluminal angioplasty (n = 1), and percutaneous transluminal coronary recanalization (n = 1). Of the 16 patients, 14 were weaned from PCPS or standard cardiopulmonary bypass. Six patients survived longer than 30 days, 3 (19 percent) of whom were discharged from the hospital. The long-term survival rate in the 6 patients who underwent coronary revascularization was 33 percent (2/6). Of the 9 patients with LV free wall rupture, 1 was discharged from the hospital. Even though it cannot be concluded, from this small number of patients, that cardiopulmonary resuscitation using PCPS improves survival, it appears that PCPS is a powerful resuscitative modality for seriously ill patients with acute myocardial infarction or LV rupture.

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Improved patient survival after cardiac arrest using a cardiopulmonary support system

Cited by 118 publications

References 12 publications

Emergency use of portable cardiopulmonary bypass

Emergency use of portable cardiopulmonary bypass

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

Emergency cardiopulmonary bypass support in patients with severe cardiogenic shock after acute myocardial infarction

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