Resuscitation efficacy of extracorporeal membrane oxygenation in non-postcardiotomy adult patients with cardiac arrest
10.3760/cma.j.issn.0253-3758.2016.11.009
- VernacularTitle:体外膜肺氧合治疗非心脏外科手术后成人心脏骤停的效果
- Author:
Lei HUANG
1
;
Yingwu LIU
;
Tong LI
;
Xiaomin HU
;
Dawei DUAN
;
Peng WU
Author Information
1. 300170,天津市第三中心医院心脏中心
- Keywords:
Heart arrest;
Cardiopulmonary resuscitation;
Treatment outcome
- From:
Chinese Journal of Cardiology
2016;44(11):945-950
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR).Methods We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015.Inclusion criteria included:18 to 75 years old;the duration from cardiac arrest to CCPR initiation ＜ 5 minutes;no recovery of spontaneous circulation within 10 min after implementation of standard CCPR,and the length of CCPR ＜ 90 minutes.Patients were divided into non-survival group (18 cases) and survival group (7 cases) based on their in-hospital outcome and the clinical characteristics were compared.Related factors of survival to discharge were analyzed by Spearman correlation analysis.Results Majority of patients (84.0％ (21/25)) developed cardiac arrest in our hospital,mostly due to acute myocardial infarction (80.0％ (20/25)).The mean duration of CCPR prior to ECMO support was 40.0 (27.5,72.0) minutes.The mean duration of ECMO support was 72.0 (47.5,128.3) hours and 9 patients (36.0％) were successfully weaned.Intensive care unit stay was significantly shorter (3.0 (1.8-7.8) days vs.16.0 (11.0-37.0) days,P ＜ 0.01),mean blood pressure at 24 and 48 hours after ECMO initiation was significantly lower ((73.2 ± 20.1) mmHg (1 mmHg =0.133 kPa) vs.(91.1 ±20.4)mmHg,P＜0.05;(63.0 ± 16.7)mmHg vs.(86.6 ± 18.0 mmHg),P ＜0.05,respectively) and platelet count at 72 hours after extracorporeal support was significantly lower ((57.0 ± 30.1) × 109/L vs.(97.3 ± 31.5) × 109/L,P ＜ 0.05) in the non-survivor group than in survival group.Spearman correlation analysis demonstrated that mean arterial pressure at 24 hours (r =0.427,P ＜0.05) and 48 hours (r =0.558,P ＜ 0.05),and platelet count at 72 hours after extracorporeal support (r =0.577,P ＜ 0.05) were significantly correlated with survival to discharge.Conclusion ECMO can be used as an effective alternative for refractory cardiac arrest in non-postcardiotomy adult patients.
