Successful resuscitation after hyperkalemic cardiac arrest during liver transplantation by converting veno-venous bypass to veno-arterial ECMO

Perfusion ◽  
2020 ◽  
pp. 026765912096389
Author(s):  
Lucas Van Hoof ◽  
Filip Rega ◽  
Sarah Devroe ◽  
Karlien Degezelle ◽  
Jacques Pirenne ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Neurological Outcome ◽  
Successful Resuscitation ◽  
Venous Bypass ◽  
Anhepatic Phase ◽  
Va Ecmo

Introduction: Intraoperative cardiac arrest (ICA) is a feared complication during liver transplantation (LTx), typically occurring during reperfusion. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used for post-reperfusion cardiac arrest. Case report: We present a case of successful resuscitation after hyperkalemic ICA during the pre-anhepatic phase of a second liver transplantation by converting veno-venous bypass (VVB) to VA-ECMO. Discussion: While this technique has been recommended for ICA during reperfusion, it has never been reported during the pre-anhepatic phase. VA-ECMO can be a lifesaving extension to cardiopulmonary resuscitation for ICA during LTx with beneficial neurological outcome by providing perfusion while the cause of ICA is reversed. Conclusion: Conversion of VVB to VA-ECMO should be considered in all patients who suffer from ICA during LTx with use of VVB. With VVB installed, conversion to VA-ECMO is fast and effective. If VVB is not used, early VA-ECMO should be considered for ICA.

Aluminium phosphide poisoning resulting in cardiac arrest, successful treatment with Extracorporeal Cardiopulmonary resuscitation (ECPR): a case report

Perfusion ◽  
2018 ◽  
Vol 33 (7) ◽  
pp. 597-598 ◽  
Author(s):  
Juan Lehoux ◽  
Zachary Hena ◽  
Megan McCabe ◽  
Giles Peek
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Successful Treatment ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Membrane Oxygenation ◽  
Aluminium Phosphide

Aluminium phosphide (AP) is a pesticide used against rodents and insects. Exposure of AP to water releases phosphine gas. Phosphine is a highly toxic mitochondrial poison to which there is no known antidote. We report a case of a 3-year-old female with accidental home exposure to AP, which resulted in cardiac arrest, who was successfully supported with extracorporeal membrane oxygenation (ECMO).

A novel escalation from veno-venous bypass to veno-venous ECMO during orthotopic liver transplantation. A case report

Perfusion ◽  
2020 ◽  
pp. 026765912097359
Author(s):  
Stylianos Voulgarelis ◽  
Johnny C Hong ◽  
Michael A Zimmerman ◽  
Joohyun Kim ◽  
John P Scott
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Collateral Circulation ◽  
Acid Base Balance ◽  
Acid Base ◽  
Venous Bypass ◽  
Base Balance ◽  
Perioperative Course ◽  
Potential Use

We describe the challenging perioperative course of a 55-year-old patient with hepatic failure requiring liver transplantation (LT). Different modalities of the extracorporeal device were successfully used, ranging from veno-veno bypass to partial and full veno-veno extracorporeal membrane oxygenation (ECMO) in order to optimize preload, reduce bleeding from the collateral circulation, optimize acid base balance and/or improve oxygenation. The case highlights the potential use of the device as a rescue method in challenging cases. Furthermore this is the first documented case that extracorporeal CO2 removal (ECCO2R) is used to optimize the biochemistry profile intraoperatively during a LT. The patient was weaned off the device at the end of the case and has been discharged home.

scholarly journals A big white dot after CPR

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Sushma Kola ◽  
Alexander D. Ginsburg ◽  
Laura Harper ◽  
Laura E. Walker ◽  
Sherri Braksick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Basilar Artery ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Successful Resuscitation ◽  
Ct Angiogram ◽  
Neurologic Event

Abstract Introduction Patients may remain comatose after the resumption of spontaneous circulation with cardiopulmonary resuscitation. A primary neurologic event may precede a cardiac standstill. Case report We present a 33-year-old patient with successful resuscitation for pulseless electrical activity and a “normal computed tomography (CT) scan.” Further scrutiny showed a hyperdense basilar artery sign (‘big white dot’) that led to a CT angiogram confirming an embolus to the proximal basilar artery. His examination showed fixed and dilated midsize (mesencephalic) pupils and extensor posturing. Endovascular retrieval of the clot was successful, but there was a devastating ischemic injury to the brainstem. Conclusion This case reminds us to consider neurologic causes of cardiac arrest.

scholarly journals Review and Outcome of Prolonged Cardiopulmonary Resuscitation

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Houssein Youness ◽  
Tarek Al Halabi ◽  
Hussein Hussein ◽  
Ahmed Awab ◽  
Kellie Jones ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Chest Compression ◽  
Neurological Outcome ◽  
Favorable Result ◽  
Pulmonary Emboli ◽  
Full Neurological Recovery

The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors.Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients.Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts.

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