Extacorporeal life support using a standard oxygenator as an element of cardiopulmonary resuscitation in cardiosurgicalpatients with in-hospital cardiac arrest

Basylev V.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Rosseikin E.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Evdokimov M.E.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Pantyuhina M.A.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Kokashkin M.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Kobzev E.E.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Extacorporeal life support using a standard oxygenator as an element of cardiopulmonary resuscitation in cardiosurgicalpatients with in-hospital cardiac arrest

Authors:

Basylev V.V., Rosseikin E.V., Evdokimov M.E., Pantyuhina M.A., Kokashkin M.V., Kobzev E.E.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2018;(5): 53‑59

DOI: 10.17116/anaesthesiology201805153

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To cite this article:

Basylev VV, Rosseikin EV, Evdokimov ME, Pantyuhina MA, Kokashkin MV, Kobzev EE. Extacorporeal life support using a standard oxygenator as an element of cardiopulmonary resuscitation in cardiosurgicalpatients with in-hospital cardiac arrest. Russian Journal of Anesthesiology and Reanimatology. 2018;(5):53‑59. (In Russ.)
https://doi.org/10.17116/anaesthesiology201805153

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The purpose of the study — to present the clinical experience of extracorporeal support using a standard oxygenator in ineffective cardiopulmonary resuscitation in cardiosurgical patients. Material and methods. The paper presents a retrospective analysis of the results of treatment of 23 patients who underwent open cardiac surgery over the period from 2013 to 2016 and required cardiopulmonary bypass as an element of a complex cardiopulmonary resuscitation due to inefficiency of standard resuscitation measures. Standard oxygenators (MedtronicAffinity NT) with a set of standard lines were used for circulatory support. The mean age of patients was 60 (28—70), the mean score by EuroSCORE I was 6 (1—14). Cardiosurgical interventions preceding the CPR included the following: concurrent surgeries (9 cases), coronary artery bypass grafting (6), heart valve replacement (4 cases), and surgeries on the aortic arch (4). Results. Central cannulation (ascending aorta-right atrium) and peripheral cannulation (femoral vein-femoral artery) were used for the cardiopumonary bypass in 16 and 7 patients, respectively. The average duration of cardiopulmonary resuscitation before CPB was 22 min (15—45 min) for survivors and the average duration of CPB was 261 min (60—1119). The average duration of cardiopulmonary resuscitation before CPB was 33 (10—90) min for those who died and the average duration of CPB was 290 (165—622) min. After CPB was started, 16 patients were transferred to the surgical radiology unit for urgent coronary angiogram with subsequent stenting of coronary arteries in 4 of them. Five patients underwent a repeated coronary artery bypass grafting after the coronary angiogram. Five patients were placed on prolonged extracorporeal membrane oxygenation (ECMO): three of them were weaned from ECMO later. The overall survival rate was 39.1% (9 patients) with a 100% expected mortality rate. Conclusion. The results obtained allow to speak about the prospects and feasibility of the use of circulatory support using a standard oxygenator in a complex cardiopulmonary resuscitation.

Keywords:

cardiopulmonary bypass

cardiopulmonary resuscitation

Authors:

Basylev V.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Rosseikin E.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Evdokimov M.E.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Pantyuhina M.A.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Kokashkin M.V.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

Kobzev E.E.

Federal Center for Cardiovascular Surgery under Ministry of Health of the Russian Federation, 440071, Penza, Russia

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