Korean Circ J.  2012 Jun;42(6):423-426. 10.4070/kcj.2012.42.6.423.

Extracorporeal Life Support After Prolonged Resuscitation for In-Hospital Cardiac Arrest due to Refractory Ventricular Fibrillation: Two Cases Resulting in a Full Recovery

• Chung JW
• Chang WH
• Hyon MS
• Youm W

• KMID: 1433863
• DOI: http://doi.org/10.4070/kcj.2012.42.6.423

Abstract

Extracorporeal life support (ECLS) has well demonstrated its efficacy in treating in-hospital cardiac arrest and is being used for broader indications. However, ECLS after prolonged cardiopulmonary resuscitation (CPR) has been traditionally contraindicated and is now challenging. Here, we introduce two cases of successful ECLS after prolonged CPR, resulting in a immediate and full recovery. Both these acute ST elevation myocardial infarction patients waiting for primary percutaneous coronary intervention (PCI) suddenly collapsed due to ventricular fibrillation (VF), which was refractory to conventional treatment. After 2 hours of conventional CPR, the ECLS had been implemented and primary PCI could be performed. Subsequent to successful revascularization, the VF was stopped with a single electric shock. In our second case, normal sinus rhythm was spontaneously restored after ECLS implementation, which was completed after 45 minutes of conventional resuscitation. Both patients made a full neurological recovery on the day of the event and were discharged with only minor complications.

Keyword

Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation

MeSH Terms

Cardiopulmonary Resuscitation
Extracorporeal Membrane Oxygenation
Heart Arrest
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Resuscitation
Shock
Ventricular Fibrillation

Figure

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  Fig. 1 Initial electrocardiogram (case 1).

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  Fig. 2 Ventricular fibrillation refractory to defibrillation (case 1).

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  Fig. 3 Right coronary angiogram before (A) and after (B) primary percutaneous coronary intervention (case 1).

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