Extracorporeal Circulation as an Adjunct to Resuscitation of the Heart

THE NUMBER OF persons who can be resuscitated following cardiac arrest during operations on the heart has progressively increased with the use of direct cardiac massage, electrical defibrillation of the heart, and the judicious use of intracardiac drugs. However, there remains a number of patients whose hearts cannot be restarted despite the fact that their neurological and physiological status is compatible with survival. The refractory nature of these cases of cardiac arrest is presumably due to the fact that cardiac massage does not produce sufficient arterial blood pressure and coronary circulation to permit recovery of myocardial function.^1,2 The sustained use of extracorporeal circulation to increase coronary perfusion in such circumstances offers a means of resuscitating these patients.

This report is concerned with five cases of intractable cardiac arrest in which prolonged periods of cardiac massage with the administration of drugs and the use of electric shock were ineffective in