BACKGROUND: Among patients with reversible conditions who sustain cardiac arrest, extracorporeal membrane oxygenation (ECMO) may support end organ perfusion while bridging to definitive therapy. METHODS: A single center retrospective review (February 2008–September 2013) of adults receiving ECMO for cardiac arrest ≥15 min duration refractory to conventional management (E-CPR) or profound cardiogenic shock following IHCA (E-CS) was conducted. The primary outcome was 30-day survival with good neurologic function defined as a cerebral performance category (CPC) of 1–2. Secondary outcomes included intensive care unit (ICU) and hospital length of say, duration of mechanical ventilation, and univariate predictors of 30-day survival with favorable neurologic function. RESULTS: Thirty-two patients (55 ± 11 years, 66% male) were included of which 22 (69%) received E-CPR and 10 (31%) received E-CS following return of spontaneous circulation (ROSC). Cardiac arrest duration was 48.8 ± 21 min for those receiving E-CPR and 25 ± 23 min for the E-CS group. Patients received ECMO support for 70.7 ± 47.6 h. Death on ECMO support occurred in 7 (21.9%) patients, while 7 (21.9%) were bridged to another form of mechanical circulatory support, and 18 (56.3%) were successfully decannulated. ICU length of stay was 7.5 [3.3–14] days and ICU survival occurred in 16 (50%) of patients. 30-Day survival was 5 (50%) in the E-CS group, 10 (45.4%) in the E-CPR group, and 15 (47%) overall. All survivors had CPC 1–2 neurologic status. CONCLUSION: In this single center experience, the use of resuscitative ECMO was associated with neurologically favorable 30-day survival in 47% of patients with prolonged IHCA (H2012:172).
BACKGROUND: Among patients with reversible conditions who sustain cardiac arrest, extracorporeal membrane oxygenation (ECMO) may support end organ perfusion while bridging to definitive therapy. METHODS: A single center retrospective review (February 2008–September 2013) of adults receiving ECMO for cardiac arrest ≥15 min duration refractory to conventional management (E-CPR) or profound cardiogenic shock following IHCA (E-CS) was conducted. The primary outcome was 30-day survival with good neurologic function defined as a cerebral performance category (CPC) of 1–2. Secondary outcomes included intensive care unit (ICU) and hospital length of say, duration of mechanical ventilation, and univariate predictors of 30-day survival with favorable neurologic function. RESULTS: Thirty-two patients (55 ± 11 years, 66% male) were included of which 22 (69%) received E-CPR and 10 (31%) received E-CS following return of spontaneous circulation (ROSC). Cardiac arrest duration was 48.8 ± 21 min for those receiving E-CPR and 25 ± 23 min for the E-CS group. Patients received ECMO support for 70.7 ± 47.6 h. Death on ECMO support occurred in 7 (21.9%) patients, while 7 (21.9%) were bridged to another form of mechanical circulatory support, and 18 (56.3%) were successfully decannulated. ICU length of stay was 7.5 [3.3–14] days and ICU survival occurred in 16 (50%) of patients. 30-Day survival was 5 (50%) in the E-CS group, 10 (45.4%) in the E-CPR group, and 15 (47%) overall. All survivors had CPC 1–2 neurologic status. CONCLUSION: In this single center experience, the use of resuscitative ECMO was associated with neurologically favorable 30-day survival in 47% of patients with prolonged IHCA (H2012:172).
Authors: Matthias Derwall; Anne Brücken; Christian Bleilevens; Andreas Ebeling; Philipp Föhr; Rolf Rossaint; Karl B Kern; Christoph Nix; Michael Fries Journal: Crit Care Date: 2015-03-26 Impact factor: 9.097
Authors: Philip Y K Pang; Gillian H L Wee; Anne E E Hoo; Ismail Mohamed Tahir Sheriff; See Lim Lim; Teing Ee Tan; Yee Jim Loh; Ka Lee Kerk; Yoong Kong Sin; Chong Hee Lim Journal: J Cardiothorac Surg Date: 2016-04-05 Impact factor: 1.637