Extracorporeal cardiopulmonary resuscitation for post-operative cardiac arrest: Indications, techniques, controversies, and early results - What is known (and unknown)

Paul J. Chai*, Jeffrey P. Jacobs, Heidi J. Dalton, John M Costello, David S. Cooper, Roxanne Kirsch, Tami Rosenthal, Joseph N. Graziano, James A. Quintessenza

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Extracorporeal cardiopulmonary resuscitation may be defined as the use of extracorporeal membrane oxygenation for the support of patients who do not respond to conventional cardiopulmonary resuscitation. Data from national and international paediatric databases indicate that the use of extracorporeal cardiopulmonary resuscitation is increasing. Guidelines from the American Heart Association suggest that any patient with refractory cardiopulmonary resuscitation and potentially reversible causes of cardiac arrest is a candidate for extracorporeal cardiopulmonary resuscitation. One possible framework for selection of patients for extracorporeal cardiopulmonary resuscitation includes dividing patients on the basis of favourable or unfavourable characteristics. Favourable characteristics include cardiac disease, witnessed event in the intensive care unit, ability to deliver effective cardiopulmonary resuscitation, active patient monitoring present, favourable arterial blood gases, and early institution of extracorporeal membrane oxygenation. Unfavourable characteristics potentially include non-cardiac disease, an unwitnessed cardiac arrest, ineffective cardiopulmonary resuscitation, and severely acidotic arterial blood gases. Considering the significant resources and cost involved in the use of extracorporeal cardiopulmonary resuscitation, its use needs to be critically examined to improve outcomes, assess neurological recovery and quality of life, and help identify populations and other factors that may help guide in the selection of patients for successful extracorporeal cardiopulmonary resuscitation.

Original languageEnglish (US)
Pages (from-to)109-117
Number of pages9
JournalCardiology in the young
Volume21
Issue numberSUPPL. 2
DOIs
StatePublished - Dec 1 2011

Keywords

  • Extracorporeal membrane oxygenation
  • congenital cardiac defect
  • paediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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    Chai, P. J., Jacobs, J. P., Dalton, H. J., Costello, J. M., Cooper, D. S., Kirsch, R., Rosenthal, T., Graziano, J. N., & Quintessenza, J. A. (2011). Extracorporeal cardiopulmonary resuscitation for post-operative cardiac arrest: Indications, techniques, controversies, and early results - What is known (and unknown). Cardiology in the young, 21(SUPPL. 2), 109-117. https://doi.org/10.1017/S1047951111001685