EMERGENCY CARDIOPULMONARY SUPPORT WITH CIRCULATORY SUPPORT DEVICES

Emergency cardiopulmonary support has been used in the United States s ince 1986, mainly by physicians at participating centers for the Natio nal Registry of Elective Supported Angioplasty. Data from the National Registry as well as the experience in three institutions from a numbe r of operators were analyzed to assess the benefits of the emergency c ardiopulmonary support application in patients with hemodynamic collap se. Patients who had experienced either cardiac arrest or hemodynamic collapse with cardiogenic shock unresponsive to pressors were placed e mergently on cardiopulmonary support. They were either then treated wi th angioplasty or with revascularization surgery. Patients placed on c ardiopulmonary support in less than 15 min experienced a 48% survival rate across the whole registry of the participating centers of the Nat ional Cardiopulmonary Bypass Registry. A two-center experience has dem onstrated a 69% survival rate. Patients treated with emergency cardiop ulmonary support who have experienced hemodynamic collapse have improv ed survivorship over any other hemodynamic support system. With increa sing experience by the operators, the results have improved for surviv orship, particularly in the early application group.