Extracorporeal cardiopulmonary resuscitation among patients with out-of-hospital cardiac arrest.
- Author:
Dae Hee CHOI
1
;
Youn Jung KIM
;
Seung Mok RYOO
;
Chang Hwan SOHN
;
Shin AHN
;
Dong Woo SEO
;
Ju Yong LIM
;
Won Young KIM
Author Information
- Publication Type:Original Article
- Keywords: Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation
- MeSH: Adult; Cardiopulmonary Resuscitation*; Emergency Service, Hospital; Extracorporeal Membrane Oxygenation; Heart Arrest; Humans; Observational Study; Out-of-Hospital Cardiac Arrest*; Prospective Studies; Tertiary Care Centers
- From: Clinical and Experimental Emergency Medicine 2016;3(3):132-138
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered as a rescue therapy for patients with refractory cardiac arrest. Identifying patients who might benefit from this potential life-saving procedure is crucial for implementation of ECPR. The objective of this study was to estimate the number of patients who fulfilled a hypothetical set of ECPR criteria and to evaluate the outcome of ECPR candidates treated with conventional cardiopulmonary resuscitation. METHODS: We performed an observational study using data from a prospective registry of consecutive adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest in a tertiary hospital between January 2011 and December 2015. We developed a hypothetical set of ECPR criteria including age ≤75 years, witnessed cardiac arrest, no-flow time ≤5 minutes, low-flow time ≤30 minutes, refractory arrest at emergency department >10 minutes, and no exclusion criteria. The primary endpoint was the proportion of good neurologic outcome of ECPR-eligible patients. RESULTS: Of 568 out-of-hospital cardiac arrest cases, 60 cases (10.6%) fulfilled our ECPR criteria. ECPR was performed for 10 of 60 ECPR-eligible patients (16.7%). Three of the 10 patients with ECPR (30.0%), but only 2 of the other 50 patients without ECPR (4.0%) had a good neurologic outcome at 1 month. CONCLUSION: ECPR implementation might be a rescue option for increasing the probability of survival in potentially hopeless but ECPR-eligible patients.
