ABSTRACT
Cardiac arrest may complicate the course of any child with cardiac disease, particularly in the postoperative period after congenital heart surgery. These children represent the most critically ill subset of an already challenging patient population. Conventional cardiopulmonary resuscitation (CPR) in adults and children has often yielded dismal results (1,2). Mechanical circulatory support has been utilized in adult patients with cardiac arrest in a number of settings but without significant improvement in outcome (3-5). The use of extracorporeal membrane oxygenation (ECMO) to resuscitate children suffering cardiac arrest after cardiac surgery has demonstrated better results than in many other pediatric patient groups (6,7). In this chapter, the use of ECMO to resuscitate children with cardiac disease who suffer cardiopulmonary arrest will be reviewed by analyzing our results with the development of a "rapid resuscitation" ECMO circuit followed by a review of the literature that pertains to this area. Although critically ill, the available data suggest that pediatric patients with cardiac disease who suffer cardiac arrest represent a salvageable group, which might do best with an aggressive approach.
