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Efficacy of emergent percutaneous cardiopulmonary support in cardiac or respiratory failure: fight or flight?

^a Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, College of Medicine, University of Hanyang, Guri, Gyeonggi-do, Korea
^b Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea
^c Department of Thoracic and Cardiovascular Surgery, Seoul Paik Hospital, College of Medicine, University of Inje, Seoul, Korea

*Corresponding author. Tel.: +82-2-3410-3480; fax: +82-2-3410-0089.

E-mail address: ytlee55{at}yahoo.com (Y.T. Lee).

We retrospectively evaluated early outcome and conducted this study to determine the predictive factors for percutaneous cardiopulmonary support (PCPS) weaning and hospital discharge. From January 2004 to December 2006, 92 patients diagnosed as cardiac or respiratory failure underwent PCPS using the Capiox emergent bypass system (Terumo, Tokyo, Japan). The mean±S.D. age was 56±18 (range, 14–85) years and 59 (64%) were male. The mean duration of PCPS was 90.9±126.0 h and that of cardiopulmonary resuscitation (CPR) was 51.1±27.8 min. The rate of weaning was 59/92 (64%) and the rate of survival to discharge was 39/92 (42%). The results indicated that the etiologic disease (myocarditis) and the cause of PCPS (cardiopulmonary arrest) are significantly correlated with weaning, whereas cardiopulmonary arrest and a shorter CPR duration (<60 min) are considerably correlated with survival. On the contrary, elderly patients (>75 years) have similar rates of weaning and survival compared with younger patients. PCPS provides an acceptable survival rate and outcome in patients with cardiac or respiratory failure. Prompt application and selection of patients with a specific disease (myocarditis) provides good results. It is also effective in elderly patients, providing hospital survival similar to that for younger patients.

Key Words: Extracorporeal membrane oxygenation; Percutaneous cardiopulmonary support; Cardiopulmonary arrest