Influence of factors before initiation of extracorporeal cardiopulmonary resuscitation on the prognosis of patients
10.3760/cma.j.issn.1671-0282.2021.10.006
- VernacularTitle:体外心肺复苏启动前因素对患者预后的影响
- Author:
Jing XU
1
;
Yimin ZHU
;
Luping WANG
;
Xingwen ZHANG
;
Maiying FAN
;
Caiwen CAO
;
Huiying XIAO
;
Lilei LIU
;
Yixiao XU
;
Shaozu LIU
;
Tao LIU
;
Xiaotong HAN
Author Information
1. 湖南师范大学附属第一医院（湖南省人民医院）急诊医学科，长沙 410005
- Keywords:
Extracorporeal cardiopulmonary resuscitation;
Extracorporeal membrane oxygenation;
Cardiac arrest;
Cardiopulmonary resuscitation;
Duration of conventional
- From:
Chinese Journal of Emergency Medicine
2021;30(10):1192-1196
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.
