scholarly journals Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR)

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Tobias Wengenmayer ◽  
Stephan Rombach ◽  
Florian Ramshorn ◽  
Paul Biever ◽  
Christoph Bode ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Flow Time ◽  
Low Flow ◽  
Extracorporeal Cardiopulmonary Resuscitation

scholarly journals Influence of low flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR)

Resuscitation ◽  
2017 ◽  
Vol 118 ◽  
pp. e16
Author(s):  
Tobias Wengenmayer ◽  
Stephan Rombach ◽  
Florian Ramshorn ◽  
Paul Biever ◽  
Christoph Bode ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Flow Time ◽  
Low Flow ◽  
Extracorporeal Cardiopulmonary Resuscitation

Abstract 11336: Experience with an Institutional Guideline on Extracorporeal Cardiopulmonary Resuscitation for Refractory in Hospital and Out of Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Marie Oebo ◽  
Nils Lars Olof Lundgren ◽  
Sarah Maiken Delaïre ◽  
Helle Laugesen ◽  
Jan J Andreasen
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Survival Rates ◽  
Flow Time ◽  
Low Flow ◽  
Exclusion Criteria ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Before And After ◽  
Improvement In Survival ◽  
Refractory Cardiac Arrest

Aim: To compare survival rates in patients with refractory cardiac arrest treated with extracorporeal cardiopulmonary resuscitation (ECPR) before and after implementation of an action card.The primary outcome was survival to discharge, and secondary outcomes were low-flow time and rate of cerebral complications. Methods: Retrospective evaluation of 37 patients treated with ECPR for refractory cardiac arrest. Information was obtained through medical records. Patients were categorized into two groups - before (BA) and after (AA) introduction of an action card. The card entailed inclusion and exclusion criteria used to evaluate the benefit of ECPR for any individual patient. Results: There were no statistically significant differences in baseline characteristics between the groups.After the introduction of the action card, survival to discharge increased from 6.7 % to 18.2 % suggesting a trend toward improved survival, despite this finding being statistically insignificant (p = 0.629).Low-flow time was reduced from 100 (12-195) minutes to 66 (30-195) minutes and the upper extreme was reduced from 195 to 153 minutes, but this was not statistically significant (p = 0.334).Cerebral factors contributed to significantly fewer deaths in AA compared with BA (p = 0.0022). Conclusion: There was no statistically significant improvement in survival rates nor a reduction in low-flow time after the implementation of an action card for the use of ECPR in patients with refractory CA. However, cerebral causes factored in fewer deaths and several patients survived despite meeting potential exclusion criteria outlined in local and international guidelines.

scholarly journals Clinical Significance of Low-Flow Time in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation: Results from the RESCUE Registry

2020 ◽  
Vol 9 (11) ◽  
pp. 3588
Author(s):  
Ik Hyun Park ◽  
Jeong Hoon Yang ◽  
Woo Jin Jang ◽  
Woo Jung Chun ◽  
Ju Hyeon Oh ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Limb Ischemia ◽  
Flow Time ◽  
Low Flow ◽  
Limited Data ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Neurologic Outcomes ◽  
Risk Of Mortality ◽  
Hospital Cardiac Arrest ◽  
Rescue Procedure

Limited data are available on the association between low-flow time and survival in patients with in-hospital cardiac arrest (IHCA) who undergo extracorporeal cardiopulmonary resuscitation (ECPR). We evaluated data from 183 IHCA patients who underwent ECPR as a rescue procedure. Patients were divided into two groups: patients undergoing extracorporeal membrane oxygenation as an adjunct to standard cardiopulmonary resuscitation for less than 38 min (n = 110) or for longer than 38 min (n = 73). The ECPR ≤ 38 min group had a significantly greater incidence of survival to discharge compared to the ECPR > 38 min group (40.0% versus 24.7%, p = 0.032). The incidence of good neurologic outcomes at discharge tended to be greater in the ECPR ≤ 38 min group than in the ECPR > 38 min group (35.5% versus 24.7%, p = 0.102). The incidences of limb ischemia (p = 0.354) and stroke (p = 0.805) were similar between the two groups, but major bleeding occurred less frequently in the ECPR ≤ 38 min group compared to the ECPR > 38 min group (p = 0.002). Low-flow time ≤ 38 min may reduce the risk of mortality and fatal neurologic damage and could be a measure of optimal management in patients with IHCA.

scholarly journals Reliability of prognostic biomarkers after prehospital extracorporeal cardiopulmonary resuscitation with target temperature management

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Walter Petermichl ◽  
Alois Philipp ◽  
Karl-Anton Hiller ◽  
Maik Foltan ◽  
Bernhard Floerchinger ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Flow Time ◽  
Low Flow ◽  
Temperature Management ◽  
Target Temperature Management ◽  
Target Temperature ◽  
Good Neurological Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) performed at the emergency scene in out-of-hospital cardiac arrest (OHCA) can minimize low-flow time. Target temperature management (TTM) after cardiac arrest can improve neurological outcome. A combination of ECPR and TTM, both implemented as soon as possible on scene, appears to have promising results in OHCA. To date, it is still unknown whether the implementation of TTM and ECPR on scene affects the time course and value of neurological biomarkers. Methods 69 ECPR patients were examined in this study. Blood samples were collected between 1 and 72 h after ECPR and analyzed for S100, neuron-specific enolase (NSE), lactate, D-dimers and interleukin 6 (IL6). Cerebral performance category (CPC) scores were used to assess neurological outcome after ECPR upon hospital discharge. Resuscitation data were extracted from the Regensburg extracorporeal membrane oxygenation database and all data were analyzed by a statistician. The data were analyzed using non-parametric methods. Diagnostic accuracy of biomarkers was determined by area under the curve (AUC) analysis. Results were compared to the relevant literature. Results Non-hypoxic origin of cardiac arrest, manual chest compression until ECPR, a short low-flow time until ECPR initiation, low body mass index (BMI) and only a minimal need of extra-corporeal membrane oxygenation support were associated with a good neurological outcome after ECPR. Survivors with good neurological outcome had significantly lower lactate, IL6, D-dimer, and NSE values and demonstrated a rapid decrease in the initial S100 value compared to non-survivors. Conclusions A short low-flow time until ECPR initiation is important for a good neurological outcome. Hypoxia-induced cardiac arrest has a high mortality rate even when ECPR and TTM are performed at the emergency scene. ECPR patients with a higher BMI had a worse neurological outcome than patients with a normal BMI. The prognostic biomarkers S100, NSE, lactate, D-dimers and IL6 were reliable indicators of neurological outcome when ECPR and TTM were performed at the emergency scene.

scholarly journals Impact of pulse pressure on clinical outcome in extracorporeal cardiopulmonary resuscitation (eCPR) patients

2021 ◽  
Author(s):  
Jonathan Rilinger ◽  
Antonia M. Riefler ◽  
Xavier Bemtgen ◽  
Markus Jäckel ◽  
Viviane Zotzmann ◽  
...  
Keyword(s):  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Pulse Pressure ◽  
Clinical Decision Making ◽  
Multivariable Analysis ◽  
Myocardial Damage ◽  
Low Flow ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Survival ◽  
Time Point

Abstract Background Hemodynamic response to successful extracorporeal cardiopulmonary resuscitation (eCPR) is not uniform. Pulse pressure (PP) as a correlate for myocardial damage or recovery from it, might be a valuable tool to estimate the outcome of these patients. Methods We report retrospective data of a single-centre registry of eCPR patients, treated at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 01/2017 and 01/2020. The association between PP of the first 10 days after eCPR and hospital survival was investigated. Moreover, patients were divided into three groups according to their PP [low (0–9 mmHg), mid (10–29 mmHg) and high (≥ 30 mmHg)] at each time point. Results One hundred forty-three patients (age 63 years, 74.1% male, 40% OHCA, average low flow time 49 min) were analysed. Overall hospital survival rate was 28%. A low PP both early after eCPR (after 1, 3, 6 and 12 h) and after day 1 to day 8 was associated with reduced hospital survival. At each time point (1 h to day 5) the classification of patients into a low, mid and high PP group was able to categorize the patients for a low (5–20%), moderate (20–40%) and high (50–70%) survival rate. A multivariable analysis showed that the mean PP of the first 24 h was an independent predictor for survival (p = 0.008). Conclusion In this analysis, PP occurred to be a valuable parameter to estimate survival and maybe support clinical decision making in the further course of patients after eCPR. Graphic abstract

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