Abstract 2840: Limitations in the Cerebral Cardiopulmonary Resuscitation Using Percutaneous Cardiopulmonary Bypass at the Hospital
Objective: Percutaneous cardiopulmonary bypass (PCPB) is a powerful cardiopulmonary cerebral resuscitation for rescuing the patients with out-of-hospital cardiogenic cardiac arrest (OHCCA) refractory to advanced cardiovascular life support (ACLS). It is necessary to introduce PCPB as quickly as possible in order to be able to expect a favorite neurological recovery. At our center, PCPB has been introduced at a point targeted to 60 minutes from the cardiac arrest and satisfactory neurological prognosis was reported in 38% of the cases. However, in order to be able to expect further successful prognosis, it is desirable to reduce timing until the introduction of PCPB. In the present study, we investigated the time from cardiac arrest to the introduction of PCPB in detail and calculated an optimal PCPB introduction time.
Method: 134 consecutive patients had been treated with PCPB during a period from January 2000 through May 2009. The time from cardiac arrest to introduction of PCPB was cumulated every 5 minutes and the following parameters were calculated: return of spontaneous circulation (ROSC), weaning of PCPB, survival to discharge, and favorite neurological recovery rates.
Results: ROSC, weaning of PCPB, survival to discharge, and favorite neurological recovery were found to be greater as the time from cardiac arrest to introduction of PCPB was decreased. In particular, neurological prognosis was further improved when PCPB was introduced within 40 minutes from cardiac arrest.
Discussion: There was a possibility that neurological prognosis can be further improved when PCPB is introduced within 40 minutes from cardiac arrest. However, the time from cardiac arrest to the arrival at the hospital is generally an average of 37 minutes so that the cases when PCPB can be introduced within 40 minutes from cardiac arrest are very limited. Thus, for the patients with OHCCA refractory to ACLS, it seems to be very important to introduce PCPB at the pre-hospital stage in the future.