Document Detail


Duration of cardiopulmonary resuscitation before extracorporeal rescue: how long is not long enough?
MedLine Citation:
PMID:  16322737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite the extensive resources required, extracorporeal cardiopulmonary resuscitation (ECPR) has been recognized as an extension of traditional CPR. The reported duration of CPR before ECPR initiation is similar between survivors and nonsurvivors, but the duration of CPR that results in futility of care is unknown. We report two cases of prolonged CPR followed by ECPR resulting in acceptable neurologic outcomes. Ventricular tachycardia developed in a 4-year-old with myocarditis, resulting in a cardiac arrest requiring CPR for 176 minutes before initiation of extracorporeal membrane oxygenation (ECMO). The patient required ECMO for 9 days. He survived neurologically normal. A ventricular arrhythmia developed in a newborn after an arterial switch procedure, leading to cardiac arrest requiring CPR for 97 minutes before ECMO, which lasted for 11 days. Hydrocephalus developed, but the patient is progressing developmentally. The upper limit of CPR duration before ECPR resulting in acceptable neurological outcomes is unknown. Many clinical and biochemical factors are potential predictors of appropriate ECPR utility. The Extracorporeal Life Support Organization registry is a plausible forum to collect data regarding ECPR. We suggest that possible predictive variables be collected. Until then, practitioners must rely on experience and judgment regarding the value of ECPR in children.
Authors:
Robert B Kelly; Penny A Porter; Andreas H Meier; John L Myers; Neal J Thomas
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  51     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-12-08     Completed Date:  2006-02-06     Revised Date:  2006-05-23    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  665-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Penn State Children's Hospital, Hershey, PA 17033-0850, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures
Cardiopulmonary Resuscitation / methods*
Child, Preschool
Extracorporeal Membrane Oxygenation*
Follow-Up Studies
Heart Arrest / therapy
Heart Defects, Congenital / diagnosis,  surgery
Hemofiltration
Humans
Infant, Newborn
Intensive Care Units, Pediatric
Male
Time Factors
Treatment Outcome

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


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