scholarly journals Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study

2019 ◽  
Vol 41 (21) ◽  
pp. 1961-1971 ◽  
Author(s):  
Wulfran Bougouin ◽  
Florence Dumas ◽  
Lionel Lamhaut ◽  
Eloi Marijon ◽  
Pierre Carli ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Conditional Logistic Regression ◽  
Time Duration ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Factors Associated ◽  
Hospital Survival ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest ◽  
Extracorporeal Cpr

Abstract Aims Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8–2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5–1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5–10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1–4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5–5.9; P = 0.002). Conclusions In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.

scholarly journals Just the Facts: Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 760-763
Author(s):  
Shannon M. Fernando ◽  
Brian Grunau ◽  
Daniel Brodie
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Tertiary Care ◽  
Spontaneous Circulation ◽  
Tertiary Care Centre ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
St Segment Elevation ◽  
St Segment ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest

A 58-year-old man is brought by the ambulance to the emergency department (ED) of a tertiary care centre following an out-of-hospital cardiac arrest. Paramedics were called by the patient's wife after he had collapsed. She immediately initiated cardiopulmonary resuscitation (CPR). Prior to his collapse, he had been complaining of chest pain. His initial rhythm in the field was ventricular fibrillation, and he received defibrillation. An automated CPR device was applied prior to transport. En route, return of spontaneous circulation is achieved. An electrocardiogram shows ST-segment elevation in the anterior leads. Just prior to arrival, the patient suffers recurrent cardiac arrest with two further rounds of unsuccessful defibrillation in the ED. At this point, a decision is made to proceed with extracorporeal cardiopulmonary resuscitation (ECPR), prior to transport for cardiac catheterization.

Management of out-of hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation in 2021

2021 ◽  
pp. 1-10
Author(s):  
Christopher Gaisendrees ◽  
Matias Vollmer ◽  
Sebastian G Walter ◽  
Ilija Djordjevic ◽  
Kaveh Eghbalzadeh ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Abstract P85: Out-of-hospital Cardiac Arrests With Extracorporeal Cardiopulmonary Resuscitation In Japan: Systematic Literature Review

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tetsuya Sakamoto ◽  
Yasufumi Asai ◽  
Ken Nagao ◽  
Yoshio Tahara ◽  
Takahiro Atsumi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Literature Review ◽  
Case Series ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Funnel Plot ◽  
Case Series Study ◽  
Series Study ◽  
Hospital Cardiac Arrest

Background: In Japan, extracorporeal cardiopulmonary resuscitation (ECPR) became popular for cardiac arrest patients who resist conventional advanced life supports. Regardless of many clinical experiences, there has been no previous systematic literature review. Methods: Case series, reports and proceedings of scientific meeting about ECPR for out-of-hospital cardiac arrest written in Japanese between January 1, 1983 and July 31, 2007 were collected with Japana Centra Revuo Medicina (medical publication database in Japan) and review by experts. The outcome and characteristics of the patients were investigated, and the influence of publication bias of the case series study was also examined by the Funnel Plot method. Results: There were 951 out-of-hospital cardiac arrest patients who received ECPR in 92 reports (including 59 case series and 33 case reports) during the period. The average of age was 38.1 (4 – 88) years old and 76.1% was male. Three hundreds and eighty-one cases (40.1%) were arrests of cardiac etiology, and 212 were non-cardiac (22.3%). The cause of arrest was not described in other 37.6%. Excluding reports for only one case, weighted survival rate at discharge of 792 cases those were clearly described the outcome was 39.5±10.0%. When the relationship between the number of cases and the survival rate at discharge in each 59 case series study was shown in figure by the Funnel Plot method, the plotted data presented the reverse-funnel type that centered on the average of survival rate of all. Conclusions: The influence of publication bias of previous reports in Japan was relatively low. ECPR can greatly contribute to improve the outcome of out-of hospital cardiac arrests.

scholarly journals In-hospital extracorporeal cardiopulmonary resuscitation (ECPR) after prolonged out-of-hospital cardiac arrest (OHCA). A case report

Resuscitation ◽  
2018 ◽  
Vol 130 ◽  
pp. e48-e49
Author(s):  
Antonella Vezzani ◽  
Tullio Manca ◽  
Andrea Ramelli ◽  
Bruno Borrello ◽  
Andrea Agostinelli ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

scholarly journals Promising candidates for extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yo Sep Shin ◽  
Youn-Jung Kim ◽  
Seung Mok Ryoo ◽  
Chang Hwan Sohn ◽  
Shin Ahn ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Performance Category ◽  
Neurologic Outcome ◽  
Low Flow ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Neurologic Status ◽  
Good Neurologic Outcome ◽  
Hospital Stays ◽  
Hospital Cardiac Arrest

AbstractPrecise criteria for extracorporeal cardiopulmonary resuscitation (ECPR) are still lacking in patients with out-of-hospital cardiac arrest (OHCA). We aimed to investigate whether adopting our hypothesized criteria for ECPR to patients with refractory OHCA could benefit. This before-after study compared 4.5 years after implementation of ECPR for refractory OHCA patients who met our criteria (Jan, 2015 to May, 2019) and 4 years of undergoing conventional CPR (CCPR) prior to ECPR with patients who met the criteria (Jan, 2011 to Jan, 2014) in the emergency department. The primary and secondary outcomes were good neurologic outcome at 6-months and 1-month respectively, defined as 1 or 2 on the Cerebral Performance Category score. A total of 70 patients (40 with CCPR and 30 with ECPR) were included. For a good neurologic status at 6-months and 1-month, patients with ECPR (33.3%, 26.7%) were superior to those with CCPR (5.0%, 5.0%) (all Ps < 0.05). Among patients with ECPR, a group with a good neurologic status showed shorter low-flow time, longer extracorporeal membrane oxygenation duration and hospital stays, and lower epinephrine doses used (all Ps < 0.05). The application of the detailed indication before initiating ECPR appears to increase a good neurologic outcome rate.

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