Using a life support machine to replicate the functions of the heart and lungs significantly improved the survival of people who suffered from out-of-hospital cardiac arrest, according to a new study published today in The Lancet(link is external).
The treatment program involving the life support machine called extracorporeal membrane oxygenation (ECMO) proved so much more effective than the standard treatment for this usually fatal condition that the trial was stopped early after enrolling just 30 of the expected 165 patients.
The study, known as the Advanced Reperfusion Strategies for Refractory Cardiac Arrest (ARREST) trial, was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
“This is the first trial to show a significant difference in outcomes after hospital admission among patients treated for out-of-hospital cardiac arrest with a team-based ECMO strategy,” said George Sopko, M.D., M.P.H., program director in the NHLBI’s Division of Cardiovascular Sciences. “We can improve outcomes for this common health condition, and we believe this study is a significant step in that direction.”
Approximately 340,000 people die of cardiac arrest each year in the United States. The condition occurs when the heart suddenly stops beating. There is no blood flow to the body, including the heart and brain. Immediate emergency treatment is essential to prevent death, but standard treatments are only marginally effective. Less than 10% of people who suffer a cardiac arrest survive. Some cardiac arrest patients do not respond to any standard cardiac arrest treatments. The ARREST investigators, led by Demetris Yannopoulos, M.D., a cardiologist and professor of medicine at the Center for Resuscitation Medicine at the University of Minnesota Medical School in Minneapolis, hypothesized that this was because these patients had severe and extensive blockages in the arteries to their heart. To find out what approach might help cardiac arrest patients, the ARREST trial compared standard treatment with treatment with ECMO as soon as possible in 30 people who suffered a cardiac arrest. The average age was 61, and 25 of the 30 patients were men.
The ECMO machine connects to a patient by tubes inserted in an artery and vein in the groin. The machine pulls blood out of the patient’s body, pumps it through a part of the machine that acts as an artificial lung, and then returns it back to the body. This gives doctors time to stabilize the patient and, if suitable, clear any blockages in the arteries of the heart