Evaluation of complication for therapeutic hypothermia with extra corporeal membrane oxygenation for out-of-hospital cardiac arrest

Introduction: Literature regarding the timing and safety of enteral feeding after cardiac arrest treated with therapeutic hypothermia and veno-arterial extra corporeal membrane oxygenation (VA-ECMO) is lacking. Aim: To describe the safety and feasibility of early enteral feeding in adult patients presenting with refractory out-of-hospital cardiac arrest treated with VA ECMO and therapeutic hypothermia. Methods: We performed a retrospective analysis of the enteral feeding patterns for patients admitted through the University of Minnesota ECPR program for refractory ventricular tachycardia or fibrillation (VT/VF). Outcomes were compared in patients with early enteral feeding initiation (within 2 days of admission) versus those with delayed enteral feeding (>2 days after admission). Results: The study included 108 consecutive patients (age 56.3+/-12.2 years, 78% male) admitted to the CICU between December 2015 and February 2019. Average CPR duration was 62.8+/-15.3min. Enteral feeding was initiated in 68(62.9%) of the sample. Enteral feeding was not started in patients expected to die within 48 hours of ICU admission. All patients underwent therapeutic hypothermia and 97.2% received neuromuscular blockade. Time to enteral feeding initiation ranged from 1 to 11 days post admission. Patients who had enteral feeding started within the first two days (43%) had similar rates of feeding interruption, (with 40% of cases in the setting of a surgical procedure or family request), gut ischemia, ileus and ventilator associated pneumonia (Table 1). Mortality and neurologic outcomes were not affected by timing of enteral feeding initiation. Conclusion: Initiation of enteral feeding within the first two days of presentation was not associated with adverse outcomes in patients with refractory cardiac arrest treated with prolonged CPR, VA ECMO, and therapeutic hypothermia.

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P2751D-dimer levels on admission predict a bleeding complication in out-of-hospital cardiac arrest patients resuscitated with extracorporeal membrane oxygenation

European Heart Journal ◽

10.1093/eurheartj/ehx502.p2751 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

T. Otani ◽

R. Matsuoka ◽

M. Morita ◽

T. Natsukawa ◽

H. Sawano ◽

...

Keyword(s):

Cardiac Arrest ◽

Extracorporeal Membrane Oxygenation ◽

Bleeding Complication ◽

Membrane Oxygenation ◽

Hospital Cardiac Arrest

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Effect of therapeutic hypothermia on the outcomes after out-of-hospital cardiac arrest according to initial ECG rhythm and witnessed status: A nationwide observational interaction analysis

Resuscitation ◽

10.1016/j.resuscitation.2015.12.012 ◽

2016 ◽

Vol 100 ◽

pp. 51-59 ◽

Cited By ~ 13

Author(s):

Sae Won Choi ◽

Sang Do Shin ◽

Young Sun Ro ◽

Kyoung Jun Song ◽

Eui Jung Lee ◽

...

Keyword(s):

Cardiac Arrest ◽

Therapeutic Hypothermia ◽

Interaction Analysis ◽

Hospital Cardiac Arrest

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Hospital mode of death in therapeutic hypothermia-treated out-of-hospital cardiac arrest patients who withdrawal of life-sustaining treatment were not applied

Resuscitation ◽

10.1016/j.resuscitation.2015.09.333 ◽

2015 ◽

Vol 96 ◽

pp. 140

Author(s):

Seung Joon Lee ◽

Young-Min Kim ◽

Ji-Hoon Kim ◽

In Soo Cho ◽

Giwoon Kim ◽

...

Keyword(s):

Cardiac Arrest ◽

Therapeutic Hypothermia ◽

Life Sustaining Treatment ◽

Hospital Cardiac Arrest ◽

Mode Of Death

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Abstract 13131: The Priority of Coronary Arteriography and Therapeutic Hypothermia After Return of Spontaneous Circulation in Patients With Out-of-hospital Cardiac Arrest. the Result of Sos-kanto 2012 Study

Circulation ◽

10.1161/circ.130.suppl_2.13131 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Shuichi Hagiwara ◽

Kiyohiro Oshima ◽

Masato Murata ◽

Makoto Aoki ◽

Kei Hayashida ◽

...

Keyword(s):

Cardiac Arrest ◽

Therapeutic Hypothermia ◽

Statistical Significance ◽

Coronary Arteriography ◽

Spontaneous Circulation ◽

P Value ◽

Return Of Spontaneous Circulation ◽

Overall Performance ◽

The Mean ◽

Hospital Cardiac Arrest

Aim: To evaluate the priority of coronary angiography (CAG) and therapeutic hypothermia therapy (TH) after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA). Patients and Methods: SOS-KANTO 2012 study is a prospective, multicenter (69 emergency hospitals) and observational study and includes 16,452 patients with OHCA. Among the cases with ROSC in that study, we intended for patients treated with both CAG and TH within 24 hours after arrival. Those patients were divided into two groups; patients in whom TH was firstly performed (TH group), and the others in whom CAG was firstly done (CAG group). We statistically compared the prognosis between the two groups. SPSS Statistics 22 (IBM, Tokyo, Japan) was used for the statistical analysis. Statistical significance was assumed to be present at a p value of less than 0.05. Result: 233 patients were applied in this study. There were 86 patients in the TH group (M/F: 74/12, mean age; 60.0±15.2 y/o) and 147 in the CAG group (M/F: 126/21, mean age: 63.4±11.1 y/o) respectively, and no significant differences were found in the mean age and M/F ratio between the two groups. The overall performance categories (OPC) one month after ROSC in the both groups were as follows; in the TH group, OPC1: 21 (24.4%), OPC2: 3 (3.5%), OPC3: 7 (8.1%), OPC4: 8 (9.3%), OPC5: 43 (50.0%), unknown: 4 (4.7%), and in the CAG group, OPC1: 38 (25.9%), OPC2: 13 (8.8%), OPC3: 15 (10.2%), OPC4: 18 (12.2%), OPC5: 57 (38.8%), unknown: 6 (4.1%). There were no significant differences in the prognosis one month after ROSC between the two groups. Conclusion: The results which of TH and CAG you give priority to over do not affect the prognosis in patients with OHCA.

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