Circulatory Support for the Patient in Cardiac Arrest: Some Research Perspectives

Abstract

Cardiopulmonary resuscitation (CPR), as a treatment for the patient in cardiac arrest, has been met with varying degrees of success. Two of the problems which have been identified include variations in the application of the technique and the initiation of the treatment with respect to the time of arrest. Modifications to the technique, such as active compression-decompression CPR, interposed abdominal compression CPR, and open chest CPR, have not significantly improved survival. It is clear that the major problem is the technique's inability to provide the necessary myocardial and cerebral blood flow required for recovery. It would seem that extracorporeal perfusion as a resuscitative technique should solve the problems associated with CPR. Extracorporeal circulatory support has met success in some applications but has not been found to be a universal answer for the patient in cardiac arrest. The purpose of this paper is to review the current status of CPR and extracorporeal circulatory support, overview the techniques employed, and summarize applied research that is ongoing in this institution.