healthmedicinet

Procedure Traditionally used during heart surgery and in the ICU may show promise as a rescue strategy for select cardiac arrest patients

Extracorporeal membrane oxygenation (ECMO), a procedure traditionally used during cardiac surgeries and in the ICU that functions as an artificial replacement for a patient’s heart and lungs, has also been used to resuscitate cardiac arrest victims in Japan, Taiwan, and South Korea. Now, a novel study of this technique in the U.S. has been completed by researchers at the Perelman School of Medicine at the University of Pennsylvania, indicating a potential role for this intervention to save patients who are unable to be resuscitated through conventional measures. The new findings will be presented at the Society for Academic Emergency Medicine annual meeting in Atlanta, Ga.

ECMO directly oxygenates and removes carbon dioxide from the blood, and is conventionally used for both respiratory and cardiac failure. The procedure requires 24/7 monitoring and care for the duration of the treatment, but provides a critical back-up for patients whose heart and lungs are so severely diseased or damaged that they can no longer function.

“Over the last decade, we have made great strides in the field of cardiac resuscitation science, including the development of novel methods of therapeutic hypothermia and the use of cardiac bypass following cardiac arrest,” said lead study author David Gaieski, MD, an associate professor of Emergency Medicine in the Perelman School of Medicine and clinical director of Penn’s Center for Resuscitation Science. “Yet cardiac arrests still take the lives of more than 300,000 Americans each year, and we are continuing to explore how to use new and expanded strategies to help save these patients. Based on the work of our colleagues in Asia, we sought to report our own experience using ECMO for a select set of patients with refractory cardiac arrest and profound shock.”

For the study, the research team used a collaborative approach between clinicians in the Department of Emergency Medicine and surgeons within the Division of Cardiovascular Surgery at Penn to assess the outcomes for select patients undergoing ECMO presenting in the emergency department (ED) and for in-hospital cardiac arrests at the Hospital of the University of Pennsylvania.

They studied the approach in patients who otherwise would have died – who were unable to be resuscitated through CPR and defibrillation and who would not have been eligible for other post-arrest therapies such as therapeutic hypothermia.