Transportation, mechanical CPR and angioplasty saved cardiac arrest patient’s life. Life-saving LUCAS case awarded at TCT congress
October 4, 2010, Lund, Sweden
Last week at the TCT congress (Transcatheter Cardiovascular Therapeutics) in Washington DC, cardiologist Dan Ioanes from Sahlgrenska University Hospital in Gothenburg, Sweden, received an award for his case presentation describing a life-saving coronary intervention (angioplasty) in a pre-hospital cardiac arrest patient. The case received special attention due to the critically ill patient, the lengthy time of resuscitation using mechanical chest compressions with the LUCAS Chest Compression System, the decision to carry out angioplasty during cardiac arrest and the successful final outcome. The LUCAS system is an external medical device that provides hands-free chest compressions during cardiopulmonary resuscitation (CPR).
The case described a 50 year-old pre-hospital patient with chest pain who went into a full cardiac arrest during ambulance transportation. LUCAS CPR was applied by the paramedics to maintain blood circulation and the patient was taken directly to the cardiac catheterization laboratory (cath lab) in the hospital. An emergency angioplasty was successfully performed during continued LUCAS CPR. After a total of two hours of LUCAS as circulatory support and then additional support on ECMO (extra corporeal membrane oxygenation) the patient returned to a normal heart rhythm. At the follow-up six months later, the patient was alive and well and living at home.
The TCT congress is the world's largest educational meeting specializing in interventional cardiovascular medicine. The above case was peer reviewed by the TCT faculty and received an award as one of three “High-Risk Angioplasty and Cardiogenic Shock” case winners. In addition, a special TCT session on “Percutaneous Coronary Intervention during Cardiac Arrest” by the Swedish Working Group presented three further cases where cardiac arrests occurring in the hospital were successfully treated during LUCAS chest compressions.
“In our case, the patient had a resistant cardiac arrest due to a myocardial infarction which could be saved by combining uninterrupted mechanical CPR with emergency angioplasty. The LUCAS device allows for simultaneous X-ray and angioplasty of a patient lying on the cath lab table– something that is difficult to achieve with manual CPR”, says Dr. Dan Ioanes.
Coronary angioplasty is increasingly used in high risk and acute patients, requiring cath labs to have a back up of circulatory support devices. The LUCAS Chest Compression System provides guidelines compliant chest compressions that can be initiated within less than a minute and that sustain adequate circulation and allow for continued PCI to treat the cause of the arrest, or as a bridge for other circulatory support devices such as ECMO.
There is a growing body of evidence supporting life-saving angioplasty during LUCAS CPR in cardiac arrest patients. A published retrospective analysis of 43 critically ill cardiac arrest patients, whose cardiac arrest occurred in the cath lab, showed that it was possible to save 11 of them using LUCAS CPR and angioplasty (Wagner et al Resuscitation. 2010; 81(4): 383-387). With regards to saving pre-hospital cardiac arrest patients with emergency angioplasty, there have been two case reports published in addition to the award-winning case above. They described cases where prolonged manual and LUCAS CPR, during transportation to the hospital and during angioplasty in the cath lab, saved the patients lives (Prause et al, Am J Emerg Med. 2010; 28(6):746.e5-6., Nilsson et al, Resuscitation. 2005; 65: 111-113).
Read more about LUCAS on www.lucas-cpr.com.
About LUCAS CPR
The LUCAS Chest Compression System is an easy-to-use and lightweight device that provides quality chest compressions in accordance with the European Resuscitation Council and American Heart Association Guidelines for CPR (cardiopulmonary resuscitation). It assists rescuers in maintaining vital blood circulation in cardiac arrest patients. LUCAS is simple to use, applied within seconds and feasible for use in a majority of cardiac arrest patients in most settings and situations. LUCAS is available in electrically powered (LUCAS 2) and pneumatically powered (LUCAS 1) versions. So far, an estimated 35,000 patients have been treated with a LUCAS. The mechanical CPR device has shown to increase operational efficacy and to improve the opportunities to save cardiac arrest patients.
About Jolife AB
Founded in 2000, Jolife AB develops and manufactures the LUCAS Chest Compression System. Jolife works closely with leading physicians, nurses, paramedics and first responders and is committed to research and development in order to continue to offer innovative products. LUCAS Chest Compression Systems are sold in over 34 countries around the world. Based in Lund in southern Sweden, Jolife markets its products through an exclusive global distribution agreement with Physio-Control, Inc., a division of Medtronic Inc. – except in Sweden, Norway and Finland, where Jolife sells directly.