The Journal of extra-corporeal technology
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J Extra Corpor Technol · Sep 2010
Case ReportsMinimizing reperfusion injuries: successful resuscitation using eCPR after cardiac arrest on a post-operative Norwood patient.
In patients with hypoplastic left heart syndrome (HLHS), the left ventricle is too small to circulate adequate oxygenated blood. If left untreated, HLHS is fatal. A 3-staged palliative procedure ultimately leading to a single ventricle physiology is the preferred management strategy for HLHS in most pediatric cardiac centers in the United States. ⋯ To minimize reperfusion injury, immediate cooling, arterial/venous shunting, minimal calcium, and hemodilution strategies were used. Once paCO2/pvCO2 gradients were minimized, we instituted sweep gas and gradually increased fiO2 as pH normalized. The patient was successfully weaned from ECMO and discharged, eCPR was used successfully in the resuscitation of this patient and reperfusion injuries were minimized despite prolonged CPR.