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Case Report

Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report

by
Boldizsár Kiss
,
Bettina Nagy
,
Ádám Pál-Jakab
,
Bálint Lakatos
,
Ádám Soltész
,
István Osztheimer
,
Krisztina Heltai
,
István Ferenc Édes
,
Endre Németh
,
Béla Merkely
and
Endre Zima
*
Heart and Vascular Centre, Semmelweis University, Budapest 1122, Hungary
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(13), 4249; https://doi.org/10.3390/jcm12134249
Submission received: 24 May 2023 / Revised: 15 June 2023 / Accepted: 19 June 2023 / Published: 25 June 2023
(This article belongs to the Special Issue Cardiac Arrest, Special Considerations for Emergency and Intensive Care)
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Abstract

ECMO has become a therapeutic modality for in- and out-of-hospital scenarios and is also suitable as a bridging therapy until further decisions and interventions can be made. Case report: A 27-year-old male patient with mechanical aortic valve prothesis had a sudden cardiac arrest (SCA). ROSC had been achieved after more than 60 min of CPR and eight DC shocks due to ventricular fibrillation (VF). The National Ambulance Service unit transported the patient to our clinic for further treatment. Due to the trauma and therapeutic INR, a CT scan was performed and ruled out bleeding. Echocardiography described severely decreased left ventricular function. Coronary angiography was negative. Due to the therapeutic refractory circulatory and respiratory failure against intensive care, VA-ECMO implantation was indicated. After four days of ECMO treatment, the patient’s circulation was stabilized without neurological deficit, and the functions of the end organs were normalized. Cardiac MRI showed no exact etiology behind SCA. ICD was implanted due to VF and SCA. The patient was discharged after 19 days of hospitalization. Conclusion: This case report points out that the early application of mechanical circulatory support could be an outcome-determinant therapeutic modality. Post-resuscitation care includes cardiorespiratory stabilization, treatment of reversible causes of malignant arrhythmia, and secondary prevention.
Keywords: cardiogenic shock; resuscitation; extracorporeal membrane oxygenation; survival cardiogenic shock; resuscitation; extracorporeal membrane oxygenation; survival

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MDPI and ACS Style

Kiss, B.; Nagy, B.; Pál-Jakab, Á.; Lakatos, B.; Soltész, Á.; Osztheimer, I.; Heltai, K.; Édes, I.F.; Németh, E.; Merkely, B.; et al. Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report. J. Clin. Med. 2023, 12, 4249. https://doi.org/10.3390/jcm12134249

AMA Style

Kiss B, Nagy B, Pál-Jakab Á, Lakatos B, Soltész Á, Osztheimer I, Heltai K, Édes IF, Németh E, Merkely B, et al. Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report. Journal of Clinical Medicine. 2023; 12(13):4249. https://doi.org/10.3390/jcm12134249

Chicago/Turabian Style

Kiss, Boldizsár, Bettina Nagy, Ádám Pál-Jakab, Bálint Lakatos, Ádám Soltész, István Osztheimer, Krisztina Heltai, István Ferenc Édes, Endre Németh, Béla Merkely, and et al. 2023. "Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report" Journal of Clinical Medicine 12, no. 13: 4249. https://doi.org/10.3390/jcm12134249

APA Style

Kiss, B., Nagy, B., Pál-Jakab, Á., Lakatos, B., Soltész, Á., Osztheimer, I., Heltai, K., Édes, I. F., Németh, E., Merkely, B., & Zima, E. (2023). Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report. Journal of Clinical Medicine, 12(13), 4249. https://doi.org/10.3390/jcm12134249

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