Resuscitation of non-postcardiotomy cardiogenic shock or cardiac arrest with extracorporeal life support: The role of bridging to intervention

Resuscitation ◽  
2012 ◽  
Vol 83 (8) ◽  
pp. 976-981 ◽  
Author(s):  
Meng-Yu Wu ◽  
Ming-Yih Lee ◽  
Chien-Chao Lin ◽  
Yu-Sheng Chang ◽  
Feng-Chun Tsai ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Postcardiotomy Cardiogenic Shock

scholarly journals Thrombotic thrombocytopenic purpura presenting as a severe peripartum cardiogenic shock: Role of myocardial biopsy and assist device for diagnosis and resuscitation

2017 ◽  
Vol 9 (7) ◽  
pp. NP8-NP9 ◽  
Author(s):  
Sébastien Champion ◽  
Dominique Belcour ◽  
Bernard Alex Gaüzère
Keyword(s):  
Cardiogenic Shock ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Cardiac Involvement ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Complete Recovery ◽  
Myocardial Biopsy ◽  
Assist Device ◽  
Thrombocytopenic Purpura

We describe the case of a peripartum thrombotic thrombocytopenic purpura with fulminant cardiogenic shock treated with extracorporeal life support. Thrombotic thrombocytopenic purpura should be considered in the case of thrombotic microangiopathy with several or severe organ involvement and needs emergent treatment with plasmapheresis (with or without rituximab). In the case of cardiac involvement, aggressive treatment should be considered given the high mortality and the potential complete recovery.

scholarly journals Reply to: The role of extracorporeal life support in patients with hypothermic cardiac arrest

Resuscitation ◽  
2019 ◽  
Vol 134 ◽  
pp. 159-160
Author(s):  
Michael M. Beyea ◽  
Bourke W. Tillmann ◽  
A. Dave Nagpal
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support

scholarly journals Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis

2016 ◽  
Vol 42 (12) ◽  
pp. 1922-1934 ◽  
Author(s):  
Dagmar M. Ouweneel ◽  
Jasper V. Schotborgh ◽  
Jacqueline Limpens ◽  
Krischan D. Sjauw ◽  
A. E. Engström ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Meta Analysis

Twenty minutes of normothermic cardiac arrest in a pig model: the role of short-term hypothermia for neurological outcome

Perfusion ◽  
2017 ◽  
Vol 33 (4) ◽  
pp. 270-277 ◽  
Author(s):  
Katharina Foerster ◽  
Christoph Benk ◽  
Friedhelm Beyersdorf ◽  
Heidi Cristina Schmitz ◽  
Karin Wittmann ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Neuron Specific Enolase ◽  
Neurological Recovery ◽  
Neurological Deficits ◽  
Short Term ◽  
Normothermic Group ◽  
Hypothermic Group

Introduction: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named “controlled integrated resuscitation device” (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept. Here, we investigated the role of immediate short-term blood cooling after experimental CA and its influence on survival and neurological recovery. Methods: Twenty-one pigs were exposed to 20 minutes of normothermic CA. Afterwards, CIRD was immediately started for 60 minutes in all animals and the heart was converted to a sinus rhythm. The pigs either received normothermic reperfusion (37°C, n=11) or the temperature was maintained at 32°C for the first 30 minutes (n=10). Thermometric, hemodynamic and serologic data were collected during the experiment. After weaning from CIRD, neurological recovery was assessed daily by a species-specific neurological deficit score (NDS; 0: normal; 500: brain death). Results: One pig in each group could not be successfully resuscitated. Due to severe neurological deficits, only 6/11 animals in the normothermic group finished the observation time of seven days with an NDS of 37±34. In the hypothermic group, all nine surviving animals reached day seven with an NDS of 16±13. Analogous to the lower NDS, animals in the hypothermic group also showed lower neuron-specific enolase end values as a marker of brain injury. Conclusions: Within this experimental setting, immediate moderate and short-term hypothermia after CA improves survival and seems to result in statistically non-significant better neurological recovery.

scholarly journals Comparison of Mechanical Support with Impella or Extracorporeal Life Support in Post-Cardiac Arrest Cardiogenic Shock: A Propensity Scoring Matching Analysis

2021 ◽  
Vol 10 (16) ◽  
pp. 3583
Author(s):  
Styliani Syntila ◽  
Georgios Chatzis ◽  
Birgit Markus ◽  
Holger Ahrens ◽  
Christian Waechter ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Survival Rates ◽  
Limb Ischemia ◽  
Spontaneous Circulation ◽  
Access Site ◽  
Baseline Characteristics ◽  
Hospital Cardiac Arrest

Our aim was to compare the outcomes of Impella with extracorporeal life support (ECLS) in patients with post-cardiac arrest cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This was a retrospective study of patients resuscitated from out of hospital cardiac arrest (OHCA) with post-cardiac arrest CS following AMI (May 2015 to May 2020). Patients were supported either with Impella 2.5/CP or ECLS. Outcomes were compared using propensity score-matched analysis to account for differences in baseline characteristics between groups. 159 patients were included (Impella, n = 105; ECLS, n = 54). Hospital and 12-month survival rates were comparable in the Impella and the ECLS groups (p = 0.16 and p = 0.3, respectively). After adjustment for baseline differences, both groups demonstrated comparable hospital and 12-month survival (p = 0.36 and p = 0.64, respectively). Impella patients had a significantly greater left ventricle ejection-fraction (LVEF) improvement at 96 h (p < 0.01 vs. p = 0.44 in ECLS) and significantly fewer device-associated complications than ECLS patients (15.2% versus 35.2%, p < 0.01 for relevant access site bleeding, 7.6% versus 20.4%, p = 0.04 for limb ischemia needing intervention). In subgroup analyses, Impella was associated with better survival in patients with lower-risk features (lactate < 8.6 mmol/L, time from collapse to return of spontaneous circulation < 28 min, vasoactive score < 46 and Horowitz index > 182). In conclusion, the use of Impella 2.5/CP or ECLS in post-cardiac arrest CS after AMI was associated with comparable adjusted hospital and 12-month survival. Impella patients had a greater LVEF improvement than ECLS patients. Device-related access-site complications occurred more frequently in patients with ECLS than Impella support.

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