Emergency Use of Cardiopulmonary Bypass

Abstract

Emergency cardiopulmonary support has been used in the United States since 1986. Physicians at participating centers for the National Registry of Elective Supported Angioplasty have contributed data on emergent cardiopulmonary support from their institutions. Results were analyzed to assess the benefits of cardiopulmonary support in patients with hemodynamic collapse. Patients with either cardiac arrest or hemodynamic collapse with cardiogenic shock unresponsive to pressor agents were placed emergently on cardiopulmonary support. Subsequent treatment comprised either angioplasty or surgical revascularization. Patients placed on cardiopulmonary support in < 20 minutes experienced a 41% survival rate across the entire registry of the participating centers of the National Cardiopulmonary Bypass Registry. Two centers with considerable experience demonstrated a 69% survival rate. Patients treated with emergency cardiopulmonary support because of hemodynamic collapse showed improved survival over any other hemodynamic support system. Results have improved for survival with increased operator experience, particularly in the early application group.

Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients

“…18 Patients suffering an unwitnessed arrest, in the terminal stage of malignancy or with cerebral hemorrhage and lacking treatment options are contraindicated for PCPS. 6,19 Survival rates strongly depend on appropriate patient selection, including age, diagnosis of underlying disease, subsequent treatment, underlying condition and duration of CPA before PCPS; 1,[3][4][5][6][7][8]10,[14][15][16][17]19 however, the appropriate indication, management and therapeutic strategy for using PCPS for CPA patients are controversial and have not been fully characterized. Furthermore, few reports have described the management details of PCPS.…”