Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis

Targeted temperature management and extracorporeal life support, particularly extracorporeal membrane oxygenation in patients undergoing cardiopulmonary resuscitation, represent outcome-enhancing strategies for patients following in- and out-of-hospital cardiac arrest. Although targeted temperature management with hypothermia between 32°C and 34°C and extracorporeal cardiopulmonary resuscitation bear separate potentials to improve outcome after out-of-hospital cardiac arrest, each is associated with bleeding risk and risk of infection. Whether the combination imposes excessive risk on patients is, however, unknown.

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Extracorporeal Cardiopulmonary Resuscitation for Out‐of‐Hospital Cardiac Arrest in Adult Patients

Journal of the American Heart Association ◽

10.1161/jaha.119.015291 ◽

2020 ◽

Vol 9 (7) ◽

Cited By ~ 3

Author(s):

Akihiko Inoue ◽

Toru Hifumi ◽

Tetsuya Sakamoto ◽

Yasuhiro Kuroda

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Life Support ◽

Extracorporeal Life Support ◽

The United States ◽

Adult Patients ◽

Temperature Management ◽

Secondary Brain Injury ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Hospital Cardiac Arrest

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) followed by targeted temperature management has been demonstrated to significantly improve the outcomes of out‐of‐hospital cardiac arrest (OHCA) in adult patients. Although recent narrative and systematic reviews on extracorporeal life support in the emergency department are available in the literature, they are focused on the efficacy of ECPR, and no comprehensively summarized review on ECPR for OHCA in adult patients is available. In this review, we aimed to clarify the prevalence, pathophysiology, predictors, management, and details of the complications of ECPR for OHCA, all of which have not been reviewed in previous literature, with the aim of facilitating understanding among acute care physicians. The leading countries in the field of ECPR are those in East Asia followed by those in Europe and the United States. ECPR may reduce the risks of reperfusion injury and deterioration to secondary brain injury. Unlike conventional cardiopulmonary resuscitation, however, no clear prognostic markers have been identified for ECPR for OHCA. Bleeding was identified as the most common complication of ECPR in patients with OHCA. Future studies should combine ECPR with intra‐aortic balloon pump, extracorporeal membrane oxygenation flow, target blood pressure, and seizure management in ECPR.

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Bridging the Gap: Extracorporeal Life Support for Out-of-Hospital Cardiac Arrest

Artificial Organs ◽

10.1111/aor.13098 ◽

2018 ◽

Vol 42 (1) ◽

pp. 5-7

Author(s):

Adam Kessler ◽

Michael Christopher Kurz

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Extracorporeal Life Support ◽

Hospital Cardiac Arrest

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Cardiopulmonary resuscitation by trained responders versus lay persons and outcomes of out-of-hospital cardiac arrest: A community observational study

Resuscitation ◽

10.1016/j.resuscitation.2017.06.024 ◽

2017 ◽

Vol 118 ◽

pp. 55-62 ◽

Cited By ~ 8

Author(s):

Yoo Mi Park ◽

Sang Do Shin ◽

Yu Jin Lee ◽

Kyoung Jun Song ◽

Young Sun Ro ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Observational Study ◽

Lay Persons ◽

Hospital Cardiac Arrest

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2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽

10.1161/cir.0000000000000731 ◽

2019 ◽

Vol 140 (24) ◽

Cited By ~ 7

Author(s):

Jonathan P. Duff ◽

Alexis A. Topjian ◽

Marc D. Berg ◽

Melissa Chan ◽

Sarah E. Haskell ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

American Heart Association ◽

Life Support ◽

American Heart ◽

Heart Association ◽

Targeted Temperature Management ◽

Temperature Management ◽

Liaison Committee ◽

Hospital Cardiac Arrest

This 2019 focused update to the American Heart Association pediatric advanced life support guidelines follows the 2018 and 2019 systematic reviews performed by the Pediatric Life Support Task Force of the International Liaison Committee on Resuscitation. It aligns with the continuous evidence review process of the International Liaison Committee on Resuscitation, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendations for advanced airway management in pediatric cardiac arrest, extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest, and pediatric targeted temperature management during post–cardiac arrest care. The writing group analyzed the systematic reviews and the original research published for each of these topics. For airway management, the writing group concluded that it is reasonable to continue bag-mask ventilation (versus attempting an advanced airway such as endotracheal intubation) in patients with out-of-hospital cardiac arrest. When extracorporeal membrane oxygenation protocols and teams are readily available, extracorporeal cardiopulmonary resuscitation should be considered for patients with cardiac diagnoses and in-hospital cardiac arrest. Finally, it is reasonable to use targeted temperature management of 32°C to 34°C followed by 36°C to 37.5°C, or to use targeted temperature management of 36°C to 37.5°C, for pediatric patients who remain comatose after resuscitation from out-of-hospital cardiac arrest or in-hospital cardiac arrest.

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