| Acute-onset dysrhythmia heralding fulminant myocarditis and refractory cardiac arrest treated with ED cardiopulmonary bypass and extracorporeal membrane oxygenation. | |
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MedLine Citation:
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PMID: 17349913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The outcome of refractory cardiac arrest is poor. The purpose of this report is to describe two cases presenting with fulminant myocarditis and refractory cardiac arrest treated with emergency department cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), with subsequent recovery. METHODS: Report of two cases. RESULTS: Two patients presented with a new onset dysrhythmia heralding fulminant myocarditis and cardiac arrest refractory to advanced life support measures. Chest compressions and positive pressure ventilation maintained oxygenation and perfusion until CPB could be initiated in the ED followed by ECMO. Spontaneous cardiac recovery followed, associated with normal neurocognitive function. CONCLUSION: While CPB and ECMO initiation in the ED is a rare event, this could provide patients with cardiac arrest presentations suggestive of myocarditis, additional time for recovery to occur. Clinical factors suggesting a good outcome are witnessed cardiac arrest in a previously healthy child with immediate initiation of effective CPR and good brain perfusion and function as evidence by substantial bodily movement during CPR. Significant dysrhythmias in a previously healthy child may herald substantial deterioration and cardiac arrest. |
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Authors:
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Loren G Yamamoto; Lynette L Young |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 25 ISSN: 0735-6757 ISO Abbreviation: Am J Emerg Med Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-12 Completed Date: 2007-04-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 348-52 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96826, USA. loreny@hawaii.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arrhythmias, Cardiac
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complications* Cardiopulmonary Bypass* Child Emergency Service, Hospital Extracorporeal Membrane Oxygenation* Female Heart Arrest / complications, therapy* Humans Myocarditis / complications* |
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