Application of extracorporeal cardiopulmonary resuscitation in adult patients with cardiac arrest
10.3760/cma.j.issn.1671-0282.2020.02.0021
- VernacularTitle:体外心肺复苏在急诊成人心脏骤停患者中的临床应用分析
- Author:
Wei LI
1
;
Jinsong ZHANG
;
Xufeng CHEN
;
Jinru LV
;
Deliang HU
;
Gang ZHANG
;
Yong MEI
;
Huazhong ZHANG
;
Feng SUN
;
Xueli JI
;
Li ZHANG
;
Xihua HUANG
;
Hui ZHANG
;
Weiwei WANG
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- From:
Chinese Journal of Emergency Medicine
2020;29(2):231-234
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on neurological outcome and survival in adults with cardiac arrest (CA).Methods:Totally 31 adult patients with ECPR were enrolled from March 2015 to June 2019 in Emergency Department of the First Affiliated Hospital of Nangjing Medical University (Jiangsu People Hospital). Patients were divided to the survival group ( n=12) and death group ( n=19). Duration of conventional cardiopulmonary resuscitation (CCPR) and extracorporeal membrane oxygenation (ECMO) and other mechanical support were compared between groups. Cerebral performance category (CPC) and hospital survival were also evaluated according to the duration of CCPR before ECPR. Results:The duration of CCPR before ECPR was significantly shorter in the survival group than that in the death group ( P=0.002). Duration of ECMO had no significant difference between the two groups ( P=0.478). The location of CA occurrence had no impact on the hospital survival rate ( P=0.716). ECPR in combination with intra-aortic balloon pump (IABP) also had no impact on the hospital survival rate ( P=0.174), and patients received continuous renal replacement therapy (CRRT) had higher hospital survival than patients without CRRT ( P = 0.032). Patients with CCPR duration ≤ 60 min had higher rates of ROSC and hospital survival ( P <0.001). CPC evaluation showed no difference between the two groups. Conclusions:ECMO can provide effective life support to CA patients, and improve their survival rates. It is recommended to initiation of ECMO implantation within 60 min after CCPR.
