Tisherman SA et al, 1990, USA | 28 year old woman brought to the emergency department with recurrent VF CPS instituted after 46 min of CPR | Case report | CPB duration | 15 hours | Small study No patients with out of hospital arrest |
Outcome | Survival to discharge, normal neurologically |
Rees MR et al, 1992, UK | Percutaneous cardiopulmonary support (CPS) started in four patients in cardiogenic shock, four patients in asystole, and one patients in resistant VF Four asystolic patients arrested in catheter lab. Patient in VF arrested on the ward 24 h after angioplasty CPS established 25–40 min after arrest | Case series | Survival in arrest group | All five patients reverted to sinus rhythm after angioplasty on CPS, and three survived to discharge One death due to aortic root rupture and one due to bronchopneumonia after 2 months 60% survival |
Survival in cardiogenic shock group | All four patients died. All had evidence of MI 5–24 h before CPS. three had angioplasty on CPS, one had AVR, and one had a large irreparable VSD |
Duration of CPS | 40 min to 29 h of successful support | |
Martin GB et al, 1998, USA | 10 patients attending the ED with out of hospital cardiac arrest unresponsive to conventional methods, placed on Fem fem CPB | Case series | Long term survivors | No long term survivors, mean survival 48 hours | No definitive interventions attempted while on CPB |
| CPB weaned after 2 hours | | Weaning from CPB | 7 successfully weaned from CPB with spontaneous circulation | |
| | | Cardiac arrest to CPB | Mean time 32 min | |
Karmy-Jones R et al, 1999
| 29 year old woman whom, while undergoing an elective gynaecological procedure, acutely arrested. ACLS ineffective. CPB was started | Case report | Outcome | Restoration of sinus rhythm after 40 min of CPB and discharge home after 2 months | |
Jaski BE et al, 1999, USA | 10 patients who had an out of hospital acute myocardial infarction and cardiac arrest were placed on percutaneous CPB | Case series | Long term survival | 4 or 10 patients are long term survivors 40% survivors | One surviving patient required an above knee amputation for leg ischaemia |
| All patients had revascularisation after start of extracorporeal cardiopulmonary bypass | | Cause of death | Neurological insufficiency in two, ineffective CPB in two, recurrent collapse after weaning in two | |
| | | Mean CPR time prior to CPB | 17 min in survivors and 54 min for non-survivors |
Nagao K et al, 2000, Japan | 36 patients arriving in the ED after out of hospital arrest, if return of spontaneous circulation could not be achieved in patients with VF after unsynchronised electric shocks, with the second administration of epinephrine, or in patients without VF after the second administration of epinephrine, emergency CPB and intra-aortic balloon pumping (IABP) were immediately performed in the emergency room. | Prospective cohort study | Return of spontaneous circulation | 32 or 36 patients had return of spontaneous circulation | Poorly presented data on CPS patients |
Fujimoto K et al, 2001, | Nine patients suffering circulatory collapse after AMI refractory to ACLS resuscitation put on CPS | Case series | Long term survival | 4 survivors although one had a poor neurological outcome | |
| All in-hospital patients | | Procedures under CPB | All patients required a surgical procedure, including VSD repair in 4 and free wall rupture in 2 | |
Kurusz M et al, 2002, USA | Review of clinical reports of CPB in cardiac arrest or cardiogenic shock | Review | Survival after cardiac arrest | 88 of 407 reported in the literature (21%) | Not systematic, search strategies not reported |
| 13 papers found reporting CPB after cardiac arrest and 17 papers reporting CPB after cardiogenic shock | | Survival after cardiogenic shock | 137 of 335 (41%) | Some papers missed |
| | | Poor survival | Patients with unwitnessed cardiac arrest or CPR over 30 min | |
Schwarz B et al, 2003, USA | 46 patients supported with venoarterial cardiopulmonary bypass, 25 because of cardiogenic shock unresponsive to pharmacologic therapy and 21 because of cardiopulmonary arrest unresponsive to ACLS | Case series | Successful weaning from CPS | 28 of 46 patients weaned | Not out of hospital patients |
Survival to discharge | 19 of 25 patients with cardiogenic shock, 3 of 21 patients with cardiopulmonary arrest |
| | | | 14% survival after cardiac arrest | |