Skip to main content
Book cover

Resuscitation pp 109–117Cite as

Extracorporeal Membrane Oxygenation Strategy in Cardiac Arrest

  • 2143 Accesses

Abstract

Sudden cardiac arrest (CA) is a catastrophic event with high mortality rate. Poor prognosis is influenced by many factors relating both to time before return of spontaneous circulation (ROSC) and to post-resuscitation care. Over time, many attempts to promote greater adherence to life-support chain and to guidelines recommendations have been performed with little benefit for survival. In 1960s, the first extracorporeal circulation devices were designed to promptly support peripheral perfusion in patients with circulatory collapse, albeit with doubtful utility. Advance in technologies made them safer and more feasible, thus allowing more extended use and improving CA outcomes. Although extracorporeal circulation performed by well-trained teams remains an indicated therapy only in carefully selected patients, we believe that it represents an important therapeutic option in CA patients.

Keywords

  • Cardiac Arrest
  • Chest Compression
  • Cardiac Arrest Patient
  • Extracorporeal Support
  • Centrifugal Blood Pump

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-88-470-5507-0_11
  • Chapter length: 9 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-88-470-5507-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   139.00
Price excludes VAT (USA)
Hardcover Book
USD   179.99
Price excludes VAT (USA)
Learn about institutional subscriptions

References

  1. Safar P, Bircher N (1988) History and phases and stages of cardiopulmonary cerebral resuscitation. In: Safar P, Bircher N (eds): Cardiopulmonary Cerebral Resuscitation, 3rd edn. Philadelphia, WB Saunders Co

    Google Scholar 

  2. Cummins RO, Ornato JP, Thies WH, Pepe PE (1991) Improving survival from sudden cardiac arrest: the “chain of survival” concept. A statement for health professionals from the advance cardiac life support. Subcommittee and the emergency cardiac care committee. Am Heart Assoc Circ 83:1832–1847

    CAS  Google Scholar 

  3. Peberdy MA, Kaye W, Ornato JP et al. for the NRCPR Investigators (2003) Cardiopulmonary resuscitation of adults in the hospital: A report of 14720 cardiac arrests from the national registry of cardiopulmonary resuscitation. Resuscitation 58:297–308

    Google Scholar 

  4. Cummins RO (1989) From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emerg Med 18(12):1269–1275

    CrossRef  PubMed  CAS  Google Scholar 

  5. Hajbaghery MA, Mousavi G, Akbari H (2005) Factors influencing survival after in-hospital cardiopulmonary resuscitation. Resuscitation 66:317–322

    CrossRef  PubMed  Google Scholar 

  6. Tunstall-Pedoe H, Bailey L, Chamberlain DA et al (1992) Survey of 3765 cardiopulmonary resuscitation in British hospitals (the BREUS study): methods and overall results. BMJ 304:1347–1351

    CrossRef  PubMed  CAS  Google Scholar 

  7. Sandroni C, Nolan J, Cavallaro F et al (2007) In-hospital cardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245

    CrossRef  PubMed  Google Scholar 

  8. Bloom HL, Shukrullah I, Cuellar JR et al (2007) Long term survival after successful in hospital cardiac arrest resuscitation. Am Heart J 153(5):831–836

    CrossRef  PubMed  Google Scholar 

  9. Chan PS, Nallamothu BK (2012) Life after death: improving outcomes following in-hospital cardiac arrest. JAMA 307(18):1917–1918

    CrossRef  CAS  Google Scholar 

  10. Girotra S, Nallamothu BK, Spertus JA et al (2012) Trends in survival after in-hospital cardiac arrest. N Engl J Med 367:1912–1920

    CrossRef  PubMed  CAS  Google Scholar 

  11. Massetti M, Tasle M, Le Page O et al (2005) Back from irreversibility:extracorporeal life support for prolonged cadiac arrest. Ann Thorac Surg 79:178–184

    CrossRef  PubMed  Google Scholar 

  12. Fredriksson M, Aune S, Bang A et al (2010) Cardiac arrest outside and inside hospital in a community: mechanims behind the differences in outcome and outcome in relation to time of arrest. Am Heart J 159:749–756

    CrossRef  PubMed  Google Scholar 

  13. Berdowski J, Berg RA, Tijssen JGP et al (2010) Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation 81:1479–1487

    CrossRef  PubMed  Google Scholar 

  14. Sasson C, Roger MAM, Dahl J et al (2010) Predictors of survival from out-of-hospital cardiac arrest. A systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes 3:63–81

    CrossRef  PubMed  Google Scholar 

  15. Adielsson A, Holleneberg J, Karlsson T et al (2011) Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in a 18 years perspective. Heart 97:1391–1396

    CrossRef  PubMed  Google Scholar 

  16. Valenzuela TD, Roe DJ, Nichol G et al (2000) Outcomes of rapid defibrillation of security officers after cardiac arrest in casinos. N Engl J Med 343:1206–1209

    CrossRef  PubMed  CAS  Google Scholar 

  17. Simpson PM, Goodger MS, Bendall JC (2010) Delayed versus immediate defibrillation in out-of-hospital cardiac arrest due to ventricular fibrillation: A systematic review and meta-analysis of randomized controlled trials. Resuscitation 81:925–931

    CrossRef  PubMed  Google Scholar 

  18. Wik L, Kramer-Johansen J, Myklebust H et al (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293:299–304

    CrossRef  PubMed  CAS  Google Scholar 

  19. Berdowski J, ten Haaf M, Tijssen JGP et al (2010) Time in recurrent ventricular fibrillation and survival of out-of-hospital cardiac arrest. Circ 122:1101–1108

    CrossRef  Google Scholar 

  20. Kennedy JH (1966) The role of assisted circulation in cardiac resuscitation. JAMA 197:97–100

    CrossRef  Google Scholar 

  21. Nichol G, Karmy-Jones R, Salerno C et al (2006) Systematic review of percutaneous cardiopulmonary bypass for cardiac arrest or cardiogenic shock states. Resuscitation 70:381–394

    CrossRef  PubMed  Google Scholar 

  22. Le Guen M, Nicolas-Robin A, Carreira S et al (2011) Extracorporeal life support following out-of-hospital refractory cardiac arrest. Crit Care 15:R29

    CrossRef  PubMed  Google Scholar 

  23. Shin TG, Choi J-H, Jo IJ et al (2011) Extracorporeal cardiopulmonary resuscitation in patients with inhospital cardiac arrest: A comparison with conventional cardiopulmonary resuscitation. Crit Care Med 39:1–7

    CrossRef  PubMed  Google Scholar 

  24. Chen Y-S, Chao A, Yu H-Y et al (2003) Analysis and results of prolonged resuscitation in cardiac arrest patients reacued by extracorporeal membrane oxygenation. J Am Coll Cardiol 41:197–203

    CrossRef  PubMed  Google Scholar 

  25. Chen Y-S, Lin J-W, Yu H-Y et al (2008) Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 372:554–561

    CrossRef  PubMed  Google Scholar 

  26. Mégarbane B, Leprince P, Deye N et al (2007) Emergency feasibility in medical intensive care unit of extracorporeal life support for refractory cardiac arrest. Intensive Care Med 33:758–764

    CrossRef  PubMed  Google Scholar 

  27. Cave DM, Gazmuri RJ, Otto CW et al (2010) Part 7: CPR techniques and devices: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circ 122:S720–S728

    CrossRef  Google Scholar 

  28. Lin J-W, Wang M-J, Yu H-Y et al (2010) Comparing the survival between extracorporeal rescue and conventional resuscitation in adult in-hospital cardiac arrest: propensity analysis of three-years data. Resuscitation 81:796–803

    CrossRef  PubMed  Google Scholar 

  29. Kjaergaard B, Frost A, Rasmussen BS et al (2011) Extracorporeal life support makes advance radiologic examinations and cardiac interventions possible in patients with cardiac arrest. Resuscitation 82:623–626

    CrossRef  PubMed  Google Scholar 

  30. Kagawa E, Inoue I, Kawagoe T et al (2010) Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest treated with cardiopulmonary resuscitation with extracorporeal life support. Resuscitation 81:968–973

    CrossRef  PubMed  Google Scholar 

  31. Soar J, Perkins GD, Abbas G et al (2010) European resuscitation council guidelines for resuscitation 2010 section 8. Resuscitation 81:1400–1433

    CrossRef  PubMed  Google Scholar 

  32. Morita S, Inokuchi S, Yamagiwa T et al (2011) Efficacy of portable and percutaneous cardiopulmonary bypass rewarming versus that of conventional internal rewarming for patients with accidental deep hypothermia. Crit Care Med 39:1064–1068

    CrossRef  PubMed  Google Scholar 

  33. Daubin C, Lehoux P, Ivascau C et al (2009) Extracorporeal life support in severe drug intoxication: a retrospective cohort study of seventeen cases. Crit Care 13:R138

    CrossRef  PubMed  Google Scholar 

  34. Rona R, Cortinovis B, Marcolin R et al (2011) Extra-corporeal life support for near-fatalmulti-drug intoxication: a case report. J Med Case R 5:231

    CrossRef  Google Scholar 

  35. Fumagalli R, Bombino M, Borelli M et al (2004) Percutaneous bridge to heart transplantation by venoarterial ECMO and transaortic left ventricular venting. Int J Artif Organs 27:410–413

    PubMed  CAS  Google Scholar 

  36. Avalli L, Maggioni E, Formica F et al (2012) Favourable survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: an Italian tertiary care centre experience. Resuscitation 83:579–583

    CrossRef  PubMed  Google Scholar 

  37. Mégarbane B, Deye N, Aout M (2011) Uselfulness of routine laboratory parameters in the decision to treat refractory cardiac arrest with extracorporeal life support. Resuscitation 82:1154–1161

    CrossRef  PubMed  Google Scholar 

  38. Hartz R, LoCicero J 3rd, Sanders JH Jr et al (1990) Clinical experience with portable cardiopulmonary bypass in cardiac patients. Ann Thorac Surg 50:437–441

    CrossRef  PubMed  CAS  Google Scholar 

  39. Chen Y-S, Yu H-Y, Huang S-C et al (2008) Extracorporeal membrane oxygenation support can extend the duration of cardiopulmonary resuscitation. Crit Care Med 36:2529–2535

    CrossRef  PubMed  Google Scholar 

  40. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O’Hearn N, VandenHoek TL, Becker LB (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293:305–310

    CrossRef  PubMed  CAS  Google Scholar 

  41. Roosa JR, Vadeboncoeur TF, Dommer PB et al (2012) CPR variability during ground ambulance transport of patients in cardiac arrest. Resuscitation. doi:10.1016/j.resuscitation.2012.07.042

    PubMed  Google Scholar 

  42. Hallstrom A, Rea TD, Sayre MR et al (2006) Manual chest compression versus use of an automated chest compression devise during resuscitation following out-of-hospital cardiac arrest. JAMA 295:2620–2628

    CrossRef  PubMed  CAS  Google Scholar 

  43. Duchateau FX, Gueye P, Curac S et al (2010) Effect of the AutoPulseTM automated band chest compression device on hemodynamics in out-of-hospital cardiac arrest resuscitation. Intensive Care Med 36:1256–1260

    CrossRef  PubMed  Google Scholar 

  44. Hock Ong ME, Fook-Chong S, Annathurai A et al (2012) Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department. Crit Care 16:R144

    CrossRef  PubMed  Google Scholar 

  45. Grasselli G, Pesenti A, Marcolin R et al (2010) Percutaneous vascular cannulation for extracorporeal life support (ECLS): a modified technique. Int J Artif Organs 33:553–557

    PubMed  Google Scholar 

  46. Nagao K, Kikushima K, Watanabe K et al (2010) Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention. Circ J 74:77–85

    CrossRef  PubMed  Google Scholar 

  47. Aissaoui N, Luyt CE, Leprince P et al (2011) Predictors of successful extracorporeal membrane oxygenation (ECMO) weaning after assistance for refractory cardiogenic shock. Intensive Care Med 37(11):1738–1745

    CrossRef  PubMed  Google Scholar 

  48. Morimura N, Sakamoto T, Nagao K (2011) Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a review of the Japanese literature. Resuscitation 82:10–14

    CrossRef  PubMed  Google Scholar 

  49. Schwarz B, Mair P, Margreiter J et al (2003) Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support. Crit Care Med 31:758–764

    CrossRef  PubMed  Google Scholar 

  50. Huang S-C, Yu H-Y, Ko W-J et al (2004) Pressure criterion for placement of distalperfusion catheter to prevent limb ischemia during adult extracorporeal life support. J Thorac Cardiovasc Surg 128:776–777

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy

    Margherita Scanziani & Leonello Avalli

  2. Department of Health Science, University of Milan-Bicocca, Monza, Italy

    Roberto Fumagalli

  3. Ospedale Niguarda Ca’ Granda, Milan, Italy

    Roberto Fumagalli

Authors
  1. Margherita Scanziani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leonello Avalli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto Fumagalli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberto Fumagalli .

Editor information

Editors and Affiliations

  1. UCO di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele, Catania, Italy

    Antonino Gullo

  2. Dept. Cardiovascular research, Istituto Mario Negri, Milano, Milano, Italy

    Giuseppe Ristagno

Rights and permissions

Reprints and Permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Scanziani, M., Avalli, L., Fumagalli, R. (2014). Extracorporeal Membrane Oxygenation Strategy in Cardiac Arrest. In: Gullo, A., Ristagno, G. (eds) Resuscitation. Springer, Milano. https://doi.org/10.1007/978-88-470-5507-0_11

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5507-0_11

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5506-3

  • Online ISBN: 978-88-470-5507-0

  • eBook Packages: MedicineMedicine (R0)