- 作者：David Skarda ; david.skarda@imail.org ; Douglass Barnhart ; Eric Scaife ; Mark Molitor ; Rebecka Meyers ; Michael Rollins
- 关键词：Pediatric ; Trauma ; Arrest ; Hypothermia ; Extracorporeal membrane oxygenation ; ECMO ; EC-CPR
- 刊名：Journal of Pediatric Surgery
- 出版年：2012
- 出版时间：December, 2012
- 年：2012
- 卷：47
- 期：12
- 页码：2239-2243
- 全文大小：223 K
Purpose
We have previously reported the use of EC-CPR for the treatment of hypothermic cardiac arrest with an overall survival of 50 % . As we have continued this protocol for an additional 5 years, we sought to update this information.Methods
We reviewed all of the activations for hypothermic cardiac arrest from 2005 to 2011. Results are presented as means with minimum and maximum values. The 95 % confidence interval for the point estimate of survival was calculated using a binomial distribution.
Results
Nine children were placed on EC-CPR for hypothermic cardiac arrest. Two patients survived to discharge and were neurologically normal. The other seven patients were adequately supported with veno-arterial EC-CPR but met brain death criteria after rewarming prompting withdrawal of support. Four of these went on to multiple organ donation. The overall survival in the series was 22 % with a 95 % confidence interval from 4 % to 58 % .
Conclusion
Cold water drowning and avalanche suffocations cause dramatic hypothermic cardiac arrests in previously robust children. A protocolized rapid response with EC-CPR can save some of these children despite prolonged periods of cardiac arrest prior to initiation of bypass. The overall survival rate is likely less than our prior more optimistic report suggested.