Abstract 312: Outcomes After Therapeutic Hypothermia During Extracorporeal Membrane Oxygenation Following Out-of-Hospital Refractory Cardiac Arrest
Background and Objective: For cardiac arrest patients who do not respond to conventional cardiopulmonary resuscitation, extracorporeal life-support (ELS) may represent an alternative therapeutic approach allowing significant survival rates. Following cardiac arrest, mild therapeutic hypothermia for 12-24 h is recommended. However, there is little clinical experience with good outcome in out-of-hospital refractory cardiac arrest. We present 5 cases of refractory cardiac arrest, who were treated with therapeutic hypothermia during extracorporeal membrane-oxygenation in the emergency department.
Results: A retrospective review of 5 out-of-hospital cardiac arrest patients (4 male and 1 female; median age, 43), who were placed on therapeutic hypothermia during ELS, was performed. All patients were unresponsive to conventional CPR and advanced cardiac life support without return of spontaneous circulation beyond 30 min. ELS was initiated under continuous cardiac massage in the emergency department. Mild therapeutic hypothermia was induced and maintained successfully for 24 h via surface cooling methods. Three patients were fully recovered consciousness from being comatose after rewarming and cessation of sedatives. Two patients were discharged with no neurological sequelae (CPC 1).
Conclusion: Mild therapeutic hypothermia during ELS in the ED can be beneficial in out-of-hospital cardiac arrest patients who are unresponsive to prolonged cardiac pulmonary resuscitation.
- © 2012 by American Heart Association, Inc.