Most cardiac arrests end in death. That could change with this machine now in Fort Worth
CPR is one of the most recognizable bystander interventions during an emergency, relying on forceful chest compressions to mimic the heart’s ability to pump blood through the body.
But CPR only works about 10% of the time when someone’s heart stops beating outside of the hospital.
“Standard CPR is fairly ineffective,” said Dr. Henry Halperin, a professor at the Johns Hopkins University School of Medicine.
Starting this year, some Tarrant County patients suffering a cardiac arrest could see their chances of surviving increase dramatically, thanks to a new process for treating these patients. In January, emergency medical services provider MedStar teamed up with Baylor Scott & White All Saints Medical to begin using a more advanced technology to increase blood flow through the body for patients whose hearts have stopped beating.
Instead of relying purely on mechanical power — like when a bystander uses their hands to compress someone’s chest — this process uses what’s known as an ECMO machine to increase blood flow.
The machines work a little bit like if your heart and lung were mechanized and operating outside of your body. Blood is taken out of a person’s body through a pump, and then pushed through an oxygenator, which exchanges carbon dioxide in the blood for oxygen. That blood is then pushed back into the person’s body, pumping oxygenated blood through the person the way their heart and lungs would normally, said Halperin.
The machines show a remarkable effect on survival for patients suffering sudden cardiac arrest: If the process is started within 30 minutes of a sudden cardiac arrest, chances of survival can increase to between 50% and 60%, Halperin said.
But they’re relatively rarely used in U.S. hospitals, in part because of the cost and expertise required to operate them. At Baylor’s campus in the Fort Worth medical district, there are three cardiac surgeons who are trained to operate them, including Dr. Andres Leal. Leal said he and his colleagues have begun treating cardiac arrest patients with the machines earlier this year.
“If you were to arrest on the Trinity Trail, and somebody’s doing chest compressions, the odds of you making it through the whole process and going back to your life is less than 10%,” Leal said. Depending on how quickly someone can get treatment, their chances of survival and recovery can increase by threefold, or even more, Leal said.
Dr. Anita Krueger, the director of the hospital’s program, said Baylor’s staff decided to add the process to its protocol because of the need in Tarrant County — heart disease is a leading cause of death — and because of its effect on survival rates.
Although other Fort Worth hospitals have the machines, they’re more commonly used for patients experiencing lung failure. During the COVID-19 pandemic, the machines were used for patients who needed more assistance than could be offered by a ventilator. Using the machines for cardiac arrest is a new and emerging tool to better treat patients.
Halperin, of Johns Hopkins, has spent most of his research career studying how CPR can be used to increase survival rates. But so far, he’s found that there’s only limited improvements through providing better CPR.
“There’s not good ways of generating adequate bood flow,” Halperin said. “ECMO CPR is one very promising way, if you can solve the logistical issue.”
Krueger stressed that trained bystanders should absolutely still do traditional CPR if someone is having a cardiac arrest. Bystander CPR can and does improve chances of survival when started quickly and correctly on someone whose heart has stopped beating.
Types of heart disease like cardiomyopathy can increase your risk of sudden cardiac arrest. And although heart attacks are different from cardiac arrests, having a heart attack can increase your chances of experiencing cardiac arrest.
Not all Fort Worth patients will be hooked up to the machine after cardiac arrest. Like any response involving the heart, the machine is more effective the sooner it starts. As part of the partnership, MedStar crews have been trained to identify good candidates for the process while responding to and transporting patients, so that the hospital’s emergency room can jump into action immediately.
This story was originally published May 11, 2022 at 5:30 AM.
