Resuscitation for cardiogenic shock with extracorporeal membrane oxygenation systems.

Between 1975 and 1993, 73 patients in cardiogenic shock were supported by a variety of venoarterial pumping (VAP) systems. There were 64 adults and 9 children. Shock was caused by myocardial infarction (MI) (26), failed percutaneous transluminal coronary angioplasty (PTCA) (25), post open heart surgery (9), viral cardiomyopathy (5), idiopathic cardiomyopathy (2), pulmonary embolism (2), hypothermia (2), and arrhythmia (2). Forty-three patients were treated with percutaneous bypass and 30 by surgical bypass. Resuscitated patients were usually bridged to further therapies such as coronary artery bypass graft (CABG), valve repair or replacement or cardiac transplantation. Overall, 35 patients (48%) survived VAP and additional therapies. We conclude that early application of complete cardiopulmonary support to patients in shock allows resuscitation and corrective therapy with an acceptable salvage rate.