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. 2015 Oct 12:20:83.
doi: 10.1186/s40001-015-0179-4.

Extracorporeal cardiopulmonary resuscitation for adult patients who underwent post-cardiac surgery

Yanyan Zhao  1 , Jialin Xing  2 , Zhongtao Du  3 , Feng Liu  4 , Ming Jia  4 , Xiaotong Hou  5
Affiliations

Extracorporeal cardiopulmonary resuscitation for adult patients who underwent post-cardiac surgery

Yanyan Zhao et al. Eur J Med Res. .

Abstract

Background: Refractory cardiac arrest (CA) occasionally develops in patients after cardiac surgery.

Objective: To examine the clinical outcomes of extracorporeal cardiopulmonary resuscitation (ECPR) in adult patients with post-cardiotomy CA.

Methods: This was a retrospective study of the 9-year experience (from January 2004 to May 2012) of the Beijing Anzhen Hospital with ECPR in adult patients with post-cardiotomy CA. At this hospital, a dedicated ECPR team is available 24/7 for emergency cases requiring ECPR. Demographic data, biochemical data, survival, morbidity, and complications were examined before, during, and after ECPR. Outcomes were compared between survivors and non-survivors.

Results: Twenty-four adult patients (19 men and 5 women; mean age: 59.3 ± 11.9 years) received ECPR support for post-cardiotomy CA. The cardiac surgery procedures included coronary artery bypass grafting (n = 20, 83.3 %), valvular surgery alone (n = 2, 8.3 %), and correction of congenital heart defects (n = 2, 8.3 %). The mean extracorporeal membrane oxygenation (ECMO) duration was 115.23 ± 70.17 h. Twenty-one patients received ECPR after intra-aortic balloon pump, and three patients received ECPR directly. The main cause of mortality was multiple system organ failure (n = 12, 50.0 %). Approximately one-half of non-survivors had severe neurologic impairments. Among 16 patients who were weaned off ECMO support, eight patients survived to hospital discharge.

Conclusions: ECPR can be effective for partial cardiopulmonary support to resuscitate adult patients suffering from refractory CA after cardiac surgery. Improvement in outcomes of patients who received ECPR requires a multidisciplinary approach to protect organ function and limit organ injury before and during cardiac support.

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Figures

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Fig. 1
Yearly distribution of ECPR cases
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