AIM: We describe a 1-year experience with extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) associated with intra-arrest hypothermia and normoxemia. METHODS: Since January 1st 2012, ECPR has been applied in our hospital to all patients less than 65 years of age and without major co-morbidities who develop refractory cardiac arrest (CA) with bystander CPR. Over a 1-year period of observation, we recorded 28-day survival with intact neurological outcome and the rate of organ donation. RESULTS: During the observational period, 24 patients were treated with ECPR, with a median age of 48 years. Ten patients had IHCA. Acute coronary syndrome and/or major arrhythmias were the main cause of arrest. Intra-arrest cooling was used in 17 patients; temperature on ECMO initiation in these patients was 32.9 °C [32-34]. The time from collapse to ECPR was 58 min [45-70] and was shorter in survivors than in non-survivors (41 min [39-58] vs. 60 min [55-77], p=0.059). Non-survivors were more likely to have coagulopathy and received more blood transfusions. Six patients (25%) survived with good neurological outcome at day 28. Four patients with irreversible brain damage had organ function suitable for donation. CONCLUSION: ECPR provided satisfactory survival rates with good neurologic recovery in refractory CA for both IHCA and OHCA. ECMO may help rapidly stabilise systemic haemodynamic status and restore organ function.
AIM: We describe a 1-year experience with extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) associated with intra-arrest hypothermia and normoxemia. METHODS: Since January 1st 2012, ECPR has been applied in our hospital to all patients less than 65 years of age and without major co-morbidities who develop refractory cardiac arrest (CA) with bystander CPR. Over a 1-year period of observation, we recorded 28-day survival with intact neurological outcome and the rate of organ donation. RESULTS: During the observational period, 24 patients were treated with ECPR, with a median age of 48 years. Ten patients had IHCA. Acute coronary syndrome and/or major arrhythmias were the main cause of arrest. Intra-arrest cooling was used in 17 patients; temperature on ECMO initiation in these patients was 32.9 °C [32-34]. The time from collapse to ECPR was 58 min [45-70] and was shorter in survivors than in non-survivors (41 min [39-58] vs. 60 min [55-77], p=0.059). Non-survivors were more likely to have coagulopathy and received more blood transfusions. Six patients (25%) survived with good neurological outcome at day 28. Four patients with irreversible brain damage had organ function suitable for donation. CONCLUSION: ECPR provided satisfactory survival rates with good neurologic recovery in refractory CA for both IHCA and OHCA. ECMO may help rapidly stabilise systemic haemodynamic status and restore organ function.
Authors: Elena Spinelli; Ryan P Davis; Xiaodan Ren; Parth S Sheth; Trevor R Tooley; Amit Iyengar; Brandon Sowell; Gabe E Owens; Martin L Bocks; Teresa L Jacobs; Lynda J Yang; William C Stacey; Robert H Bartlett; Alvaro Rojas-Peña; Robert W Neumar Journal: Crit Care Med Date: 2016-02 Impact factor: 7.598
Authors: Joseph E Tonna; Nicholas J Johnson; John Greenwood; David F Gaieski; Zachary Shinar; Joseph M Bellezo; Lance Becker; Atman P Shah; Scott T Youngquist; Michael P Mallin; James Franklin Fair; Kyle J Gunnerson; Cindy Weng; Stephen McKellar Journal: Resuscitation Date: 2016-08-11 Impact factor: 5.262
Authors: Christian Jung; Kyra Janssen; Mirko Kaluza; Georg Fuernau; Tudor Constantin Poerner; Michael Fritzenwanger; Ruediger Pfeifer; Holger Thiele; Hans Reiner Figulla Journal: Clin Res Cardiol Date: 2015-08-25 Impact factor: 5.460
Authors: Harald Arne Bergan; Per Steinar Halvorsen; Helge Skulstad; Thor Edvardsen; Erik Fosse; Jan Frederik Bugge Journal: Intensive Care Med Exp Date: 2015-09-03