Chih-Hsien Wang1, Nai-Kuan Chou2, Lance B Becker3, Jou-Wei Lin4, Hsi-Yu Yu5, Nai-Hsin Chi2, Shu-Chien Hunag2, Wen-Je Ko2, Shoei-Shen Wang2, Li-Jung Tseng2, Ming-Hsien Lin5, I-Hui Wu2, Matthew Huei-Ming Ma6, Yih-Sharng Chen7. 1. Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan; Center for Resuscitation Science, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan. 2. Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. 3. Center for Resuscitation Science, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. 4. Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Doulu, Yun-lin, Taiwan. 5. Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan. 6. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. 7. Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: yschen1234@gmail.com.
Abstract
PURPOSE: The aim was to investigate the effects of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) and compare the results with those of in-hospital cardiac arrest (IHCA). METHODS: We analyzed our extracorporeal membrane oxygenation (ECMO) results for patients who received ECPR for OHCA or IHCA in the last 5 years. Pre-arrest, resuscitation, and post-resuscitative data were evaluated. RESULTS: In the last 5 years, ECPR was used 230 times for OHCA (n=31) and IHCA (n=199). The basic demographic data showed significant differences in age, cardiomyopathy, and location of the initial CPR. Duration of ischemia was shorter in the IHCA group (44.4±24.7 min vs. 67.5±30.6 min, p<0.05). About 50% of each group underwent a further intervention to treat the underlying etiology. ECMO was maintained for a shorter duration in the OHCA patients (61±48 h vs. 94±122 h, p<0.05). Survival to discharge was similar in the two groups (38.7% for OHCA vs. 31.2% for IHCA, p>0.05), as was the favorable outcome rate (25.5% for OHCA vs. 25.1% for IHCA, p>0.05). Survival was acceptable (about 33%) in both groups when the duration of ischemia was no longer than 75 min. CONCLUSIONS: In addition to having a beneficial effect in IHCA, ECPR can lead to survival and a positive neurological outcome in selected OHCA patients after prolonged resuscitation. Our results suggest that further investigation of the use of ECMO in OHCA is warranted.
PURPOSE: The aim was to investigate the effects of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) and compare the results with those of in-hospital cardiac arrest (IHCA). METHODS: We analyzed our extracorporeal membrane oxygenation (ECMO) results for patients who received ECPR for OHCA or IHCA in the last 5 years. Pre-arrest, resuscitation, and post-resuscitative data were evaluated. RESULTS: In the last 5 years, ECPR was used 230 times for OHCA (n=31) and IHCA (n=199). The basic demographic data showed significant differences in age, cardiomyopathy, and location of the initial CPR. Duration of ischemia was shorter in the IHCA group (44.4±24.7 min vs. 67.5±30.6 min, p<0.05). About 50% of each group underwent a further intervention to treat the underlying etiology. ECMO was maintained for a shorter duration in the OHCA patients (61±48 h vs. 94±122 h, p<0.05). Survival to discharge was similar in the two groups (38.7% for OHCA vs. 31.2% for IHCA, p>0.05), as was the favorable outcome rate (25.5% for OHCA vs. 25.1% for IHCA, p>0.05). Survival was acceptable (about 33%) in both groups when the duration of ischemia was no longer than 75 min. CONCLUSIONS: In addition to having a beneficial effect in IHCA, ECPR can lead to survival and a positive neurological outcome in selected OHCA patients after prolonged resuscitation. Our results suggest that further investigation of the use of ECMO in OHCA is warranted.
Authors: Christelle Lardi; Coraline Egger; Robert Larribau; Marc Niquille; Patrice Mangin; Tony Fracasso Journal: Int J Legal Med Date: 2015-01-27 Impact factor: 2.686
Authors: Guido Michels; Tobias Wengenmayer; Christian Hagl; Christian Dohmen; Bernd W Böttiger; Johann Bauersachs; Andreas Markewitz; Adrian Bauer; Jan-Thorsten Gräsner; Roman Pfister; Alexander Ghanem; Hans-Jörg Busch; Uwe Kreimeier; Andreas Beckmann; Matthias Fischer; Clemens Kill; Uwe Janssens; Stefan Kluge; Frank Born; Hans Martin Hoffmeister; Michael Preusch; Udo Boeken; Reimer Riessen; Holger Thiele Journal: Clin Res Cardiol Date: 2018-09-04 Impact factor: 5.460
Authors: G Michels; T Wengenmayer; C Hagl; C Dohmen; B W Böttiger; J Bauersachs; A Markewitz; A Bauer; J-T Gräsner; R Pfister; A Ghanem; H-J Busch; U Kreimeier; A Beckmann; M Fischer; C Kill; U Janssens; S Kluge; F Born; H M Hoffmeister; M Preusch; U Boeken; R Riessen; H Thiele Journal: Med Klin Intensivmed Notfmed Date: 2018-09 Impact factor: 0.840
Authors: G Michels; T Wengenmayer; C Hagl; C Dohmen; B W Böttiger; J Bauersachs; A Markewitz; A Bauer; J-T Gräsner; R Pfister; A Ghanem; H-J Busch; U Kreimeier; A Beckmann; M Fischer; C Kill; U Janssens; S Kluge; F Born; H M Hoffmeister; M Preusch; U Boeken; R Riessen; H Thiele Journal: Anaesthesist Date: 2018-08 Impact factor: 1.041
Authors: Morgann Loaec; Adam S Himebauch; Todd J Kilbaugh; Robert A Berg; Kathryn Graham; Richard Hanna; Heather A Wolfe; Robert M Sutton; Ryan W Morgan Journal: Resuscitation Date: 2020-05-15 Impact factor: 5.262
Authors: Matteo Pozzi; Catherine Koffel; Camelia Djaref; Daniel Grinberg; Jean Luc Fellahi; Elisabeth Hugon-Vallet; Cyril Prieur; Jacques Robin; Jean François Obadia Journal: J Thorac Dis Date: 2017-07 Impact factor: 2.895
Authors: Javier J Lasa; Rachel S Rogers; Russell Localio; Justine Shults; Tia Raymond; Michael Gaies; Ravi Thiagarajan; Peter C Laussen; Todd Kilbaugh; Robert A Berg; Vinay Nadkarni; Alexis Topjian Journal: Circulation Date: 2015-12-03 Impact factor: 29.690