Extracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. The authors used a 2 × 2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 min of untreated VF and 10 min of CPR, and were randomized to receive epinephrine versus placebo for another 35 min. Animals were further randomized to left anterior descending artery (LAD) reperfusion at minute 45 with ongoing CPR versus venoarterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved with ECMO whereas epinephrine showed no effect.
Bibliographical noteFunding Information:
This study was funded by a grant (R01HL108926) to Dr. Yannopoulos from the National Institutes of Health National Heart, Lung, and Blood Institute. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Bartos and Voicu contributed equally to this work.
© 2017 The Authors
Copyright 2017 Elsevier B.V., All rights reserved.
- ST-segment elevation myocardial infarction
- advanced cardiopulmonary life support
- cardiac arrest
- cardiopulmonary resuscitation
- extracorporeal membrane oxygenation
- ischemic refractory ventricular fibrillation
- ventricular fibrillation