scholarly journals Use of Extracorporeal Membrane Oxygenation in Patients with Refractory Cardiac Arrest due to Severe Persistent Hypothermia: About 2 Case Reports and a Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Rachid Attou ◽  
Sébastien Redant ◽  
Thierry Preseau ◽  
Kevin Mottart ◽  
Louis Chebli ◽  
...  

We report the cases of two patients experiencing persistent severe hypothermia. They were 45 and 30 years old and had a witnessed cardiac arrest managed with mechanized cardiopulmonary resuscitation (CPR) for 4 and 2.5 hours, respectively. Extracorporeal membrane oxygenation was used in both patients who fully recovered without any neurological sequelae. These two cases illustrate the important role of extracorporeal CPR (eCPR) in persistent severe hypothermia leading to cardiac arrest.

2020 ◽  
Vol 46 (5) ◽  
pp. 973-982 ◽  
Author(s):  
Dirk Lunz ◽  
Lorenzo Calabrò ◽  
Mirko Belliato ◽  
Enrico Contri ◽  
Lars Mikael Broman ◽  
...  

Perfusion ◽  
2019 ◽  
Vol 35 (1) ◽  
pp. 82-85 ◽  
Author(s):  
Christophe Beyls ◽  
Pierre Huette ◽  
Mathieu Guilbart ◽  
Alphonse Nzonzuma ◽  
Osama Abou Arab ◽  
...  

The objective of the study is to describe an emergency procedure for left ventricle venting during veno-arterial extracorporeal life support for refractory cardiac arrest. Veno-arterial extracorporeal membrane oxygenation is widely used in refractory cardiac arrest but is characterized by an increase in left ventricle afterload, which may impair cardiac contractility improvement. Different left ventricle venting techniques are available. We report the use of a surgical approach with sternotomy for left ventricle venting in a 21-year-old patient who was placed under veno-arterial extracorporeal membrane oxygenation for refractory cardiac arrest with severe pulmonary edema, respiratory failure, and left ventricle stasis. A 21-year-old woman was admitted for laparoscopic sleeve gastrectomy. In the recovery room, she developed a refractory circulatory shock. Transthoracic echocardiography revealed a dilated cardiomyopathy with severe left ventricle systolic dysfunction (left ventricle ejection fraction at 20%). Coronary angiogram was normal. On day 2, she underwent laparotomy for sepsis and she presented cardiac arrest secondary to ventricular tachycardia. We proceeded to peripheral veno-arterial extracorporeal membrane oxygenation as the cardiac arrest was refractory. A miniaturized veno-arterial extracorporeal membrane oxygenation system was implanted into the right femoral vessels onsite .The low flow duration was 40 minutes. Veno-arterial extracorporeal membrane oxygenation blood flow was set to 3 L min−1, resulting in a closed aortic valve and a massive pulmonary edema. Transesophageal echocardiography showed left ventricular ejection fraction at 5% without aortic valve opening. We first implanted an intra-aortic balloon pump without clinical improvement. Transesophageal echocardiography revealed massive thrombus formation into the aortic root. We decided to perform an open surgical approach for left ventricle unload using a transmitral cannula (22 Fr) via the right superior pulmonary vein connected to the inflow tube of the veno-arterial extracorporeal membrane oxygenation with Y connection. Transesophageal echocardiography showed a full opening of aortic valve and elimination of valve aortic thrombus. Chest radiography showed a significant decrease of pulmonary congestion. We were able to withdraw extracorporeal life support organization on day 10 and discharged on day 54. Clinical explorations reveal a fulminant rocuronium-related hypersensitivity myocarditis. This salvage surgical technique using a modified central veno-arterial extracorporeal membrane oxygenation cannulation technique has efficiently decreased blood stasis and permitted rapid recovery.


CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Riyad B. Abu-Laban ◽  
David Migneault ◽  
Meghan R. Grant ◽  
Vinay Dhingra ◽  
Anthony Fung ◽  
...  

AbstractExtracorporeal membrane oxygenation (ECMO) is a method to provide temporary cardiac and respiratory support to critically ill patients. In recent years, the role of ECMO in emergency departments (EDs) for select adults has increased. We present the dramatic case of a 29-year-old man who was placed on venoarterial ECMO for cardiogenic shock and respiratory failure following collapse and protracted ventricular fibrillation cardiac arrest in our ED. Resuscitation efforts prior to ECMO commencement included 49 minutes of virtually continuous cardiopulmonary resuscitation (CPR), 11 defibrillations, administration of numerous medications, including a thrombolytic agent, while CPR was ongoing, percutaneous coronary intervention and stenting for a mid–left anterior descending coronary artery dissection and thrombotic occlusion, inotropic support, and intra-aortic balloon pump counterpulsation. Over the next 48 hours following ECMO commencement, the patient’s cardiorespiratory function rapidly improved, and he was discharged home 9 days after admission with no neurologic sequelae. The history, indications, and increasing role of ECMO in a range of conditions, including cardiac arrest, are reviewed.


2013 ◽  
Vol 15 (3) ◽  
pp. 47-51 ◽  
Author(s):  
Chiara Lazzeri ◽  
Andrea Sori ◽  
Pasquale Bernardo ◽  
Claudio Picariello ◽  
Gian Franco Gensini ◽  
...  

Resuscitation ◽  
2013 ◽  
Vol 84 (12) ◽  
pp. e145-e146 ◽  
Author(s):  
Paola Attanà ◽  
Chiara Lazzeri ◽  
Marco Chiostri ◽  
Gian Franco Gensini ◽  
Serafina Valente

Sign in / Sign up

Export Citation Format

Share Document