Variability of extracorporeal cardiopulmonary resuscitation utilization for refractory adult out-of-hospital cardiac arrest: an international survey study.
- Author:
Patrick J COPPLER
1
;
Benjamin S ABELLA
;
Clifton W CALLAWAY
;
Minjung Kathy CHAE
;
Seung Pill CHOI
;
Jonathan ELMER
;
Won Young KIM
;
Young Min KIM
;
Michael KURZ
;
Joo Suk OH
;
Joshua C REYNOLDS
;
Jon C RITTENBERGER
;
Kelly N SAWYER
;
Chun Song YOUN
;
Byung Kook LEE
;
David F GAIESKI
Author Information
- Publication Type:Original Article
- Keywords: Extracorporeal membrane oxygenation; Heart arrest; Cardiopulmonary resuscitation
- MeSH: Adult*; Cardiopulmonary Resuscitation*; Catheterization; Coma; Extracorporeal Membrane Oxygenation; Heart Arrest; Humans; Hypothermia; Korea; Out-of-Hospital Cardiac Arrest*; Practice Guidelines as Topic; Prospective Studies; Research Personnel; Shock; Standard of Care
- From: Clinical and Experimental Emergency Medicine 2018;5(2):100-106
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: A growing interest in extracorporeal cardiopulmonary resuscitation (ECPR) as a rescue strategy for refractory adult out-of-hospital cardiac arrest (OHCA) currently exists. This study aims to determine current standards of care and practice variation for ECPR patients in the USA and Korea. METHODS: In December 2015, we surveyed centers from the Korean Hypothermia Network (KORHN) Investigators and the US National Post-Arrest Research Consortium (NPARC) on current targeted temperature management and ECPR practices. This project analyzes the subsection of questions addressing ECPR practices. We summarized survey results using descriptive statistics. RESULTS: Overall, 9 KORHN and 4 NPARC centers reported having ECPR programs and had complete survey data available. Two KORHN centers utilized extracorporeal membrane oxygenation only for postarrest circulatory support in patients with refractory shock and were excluded from further analysis. Centers with available ECPR generally saw a high volume of OHCA patients (10/11 centers care for >75 OHCA a year). Location of, and providers trained for cannulation varied across centers. All centers in both countries (KORHN 7/7, NPARC 4/4) treated comatose ECPR patients with targeted temperature management. All NPARC centers and four of seven KORHN centers reported having a standardized hospital protocol for ECPR. Upper age cutoff for eligibility ranged from 60 to 75 years. No absolute contraindications were unanimous among centers. CONCLUSION: A wide variability in practice patterns exist between centers performing ECPR for refractory OHCA in the US and Korea. Standardized protocols and shared research databases might inform best practices, improve outcomes, and provide a foundation for prospective studies.
