Abstract 65: Using Percutaneous Cardiopulmonary Bypass in Patients with Cardiac Arrest Caused by Accidental Hypothermia
Background: Deep accidental hypothermia is associated with marked depression of critical body functions that may lead to cardiac arrest. For these patients, active internal rewarming techniques are needed. Though there are many active internal rewarming techniques, including peritoneal lavage with warm fluids, pleural lavage with warm saline trough chest tubes, and cardiopulmonary bypass (CPB), the relationship between the rewarming strategies and survival rate remains unclear.
Objectives: To determine the effect of percutaneous cardiopulmonary bypass PCPB in patients with hypothermic cardiac arrest.
Methods: Patients with hypothermic cardiac arrest admitted to our hospital from January 2004 to January 2006 were included (n=12. 11 male, age 66±5 years). Patients were divided into two groups according to rewarming techniques: 6 patients using PCPB for rewarming (Gr-P), and 6 patients rewarmed by body cavity lavage with warm fluid (Gr-N). In Gr-P, oxygenator combined with a heat exchanger was used. In Gr-N, tubes were placed in the stomach, bladder, pleural cavity and intraperitoneal space. Through those tubes, infusion and drainage of warm fluid was performed.
Results: There were no difference in age, rate of lay-person CPR, body temperature at arrival, serum potassium levels and blood gas analysis beyond the two groups. The rewarming time was shorter in Gr-P (Gr-P 77±19 vs Gr-N 150±45 min, p=0.004), and the rewarming rate was higher inGr-P (4.9±1.0 vs 2.4±1.2 °C/hour, p=0.004). Return of spontaneous circulation was seen in 6 cases of Gr-P (100%), 0 cases of Gr-N.
Conclusions: PCPB is a powerful rewarming technique for patients with hypothermic cardiac arrest, and may improve the prognosis for those victims.