Document Detail


Acute-onset dysrhythmia heralding fulminant myocarditis and refractory cardiac arrest treated with ED cardiopulmonary bypass and extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  17349913     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Loren G Yamamoto; Lynette L Young
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  25     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-04-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  348-52     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96826, USA. loreny@hawaii.edu
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / complications*
Cardiopulmonary Bypass*
Child
Emergency Service, Hospital
Extracorporeal Membrane Oxygenation*
Female
Heart Arrest / complications,  therapy*
Humans
Myocarditis / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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