Resuscitation of the moribund patient using portable cardiopulmonary bypass

Abstract

The advancements in extracorporeal cardiopulmonary support through oxygenation and pumping units have permitted the explosive development of heart surgery. A battery-powered portable cardiopulmonary bypass machine has been used in 39 patients whose conditions precluded transport to the operating room. Nineteen patients with massive pulmonary emboli, 10 with extensive cardiopulmonary trauma, who had sustained massive drug overdose, and 2 with cardiogenic shock from acute myocardial infarction were successfully placed on cardiopulmonary bypass at the bedside within 15 minutes of cardiac arrest using femoral artery and femoral vein cannulation. Six patients who had cardiac arrest and suspected massive pulmonary emboli were found to have no mechanical cause for their arrest. Thirteen of the patients with massive pulmonary emboli were saved. Eight of the 10 patients who required portable cardiopulmonary bypass for massive traumatic thoracic injuries had control of hemorrhage and repair, allowing bypass to be discontinued. Two of these 8 patients had sustained transection of the proximal left anterior descending coronary artery. Sixteen patients survived for more than 30 days, and there are 15 long-term survivors.