January 1, 1990Catheterization and Cardiovascular Diagnosis
Emergency cardiopulmonary bypass support in patients with cardiac arrest in the catheterization laboratory
Key result
Percutaneously instituted cardiopulmonary bypass support stabilized patients and led to survival in 4 of 7 patients (57.1%) with cardiac arrest in the cath lab unresponsive to ACLS.
Why the study?
Does percutaneously instituted cardiopulmonary bypass support improve survival in patients with cardiac arrest in the catheterization laboratory unresponsive to ACLS?
Population
7 patients not responding to advanced cardiac life support following cardiac arrest in the catheterization…
Design
Case_series
Follow-up
mean 6 months
Authors
Discussion
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Implication
May support percutaneous bypass in refractory cath lab arrest; leaves open survival benefit pending controlled studies.
Key Points
- Assess the feasibility and outcomes of emergency percutaneous cardiopulmonary bypass in patients with cardiac arrest unresponsive to advanced cardiac life support during catheterization procedures.
- Reviewed seven patients (N=7) who suffered cardiac arrest unresponsive to standard advanced cardiac life support in the cardiac catheterization laboratory.
- Instituted emergency percutaneous cardiopulmonary bypass 10 to 45 minutes (mean, 21 minutes) after cardiac arrest onset.
- Tracked hemodynamic stabilization, transition to definitive revascularization, and survival outcomes at a mean follow-up of 6 months.
- Cardiopulmonary bypass maintained flows of 4.0 to 5.2 L/min and mean arterial pressures of 70 to 110 mm Hg, enabling 6 of 7 patients to regain consciousness and normalizing acid-base status in all patients.
- Emergency revascularization was performed in 5 patients, including coronary bypass surgery in 3 patients and coronary angioplasty in 2 patients.
- Four of seven patients (57%) survived and remained alive and asymptomatic or NYHA class I at 6-month follow-up, while three patients died (one post-surgery and two not eligible for revascularization).
Study Design
Type
Case Report (n=7)
Structured PICO
Does percutaneously instituted cardiopulmonary bypass support improve survival in patients with cardiac arrest in the catheterization laboratory unresponsive to ACLS?
P
Population
7 patients with cardiac arrest in the catheterization laboratory unresponsive to ACLS who underwent percutaneously instituted cardiopulmonary bypass support, followed for a mean of 6 months.
I
Intervention
Percutaneously instituted cardiopulmonary bypass support (instituted 10-45 min following onset of cardiac arrest, total bypass time 1.5-8.5 hr)
O
Outcome
Survivalhard clinical
Emergency percutaneous cardiopulmonary bypass can stabilize patients and improve survival following ACLS-unresponsive cardiac arrest in the catheterization laboratory.
Cite This Study
Shawl et al. (1990) conducted a case report in Cardiac arrest in the catheterization laboratory unresponsive to ACLS (n=7). Percutaneously instituted cardiopulmonary bypass support was evaluated on Survival. Percutaneously instituted cardiopulmonary bypass support stabilized patients and led to survival in 4 of 7 patients (57.1%) with cardiac arrest in the cath lab unresponsive to ACLS.