Extra corporeal life support makes advanced radiologic examinations and cardiac interventions possible in patients with cardiac arrest

OBJECTIVES: Extra corporeal life support (ECLS) with a mobile system is an option in the treatment of cardiac arrest often of unknown reason. After commencing ECLS the search for a provoking origin may include advanced radiologic examinations before deciding further treatment. METHODS: Fifty-eight patients with circulatory arrest were treated with ECLS. In 15 cases the patient went through CT scans of the cerebrum, thorax and abdomen, pulmonary angiography, and or invasive cardiologic examinations. Two patients were transported in ambulance and helicopter on ECLS before the examinations. RESULTS: The underlying diagnosis in the 15 patients were: lung embolism (n=6), accidental hypothermia (n=2), myocardial infarction (n=2), WPW syndrome (n=1), sepsis (n=1), disseminated intravascular coagulation (n=2), high voltage accident (n=1). Only in the last mentioned patient the CT scan was indicative of major brain damage, and further treatment was stopped. Five of the 15 examined patients survived. The diagnoses in the survivors were lung embolism (n=2), myocardial infarction (n=1), WPW syndrome (n=1), and accidental hypothermia (n=1). The results of the radiologic examinations had great influence on all treatments. CONCLUSIONS: It is possible to make radiological examinations i.e., CT scans, pulmonary and coronary angiography in patients suffering heart arrest of unknown origin with the use of ECLS in order to improve patient treatment in this very high-risk population.