Dirk Lunz1, Lorenzo Calabrò2,3, Mirko Belliato4, Enrico Contri4, Lars Mikael Broman5, Anna Maria Scandroglio2, Daniel Patricio3, Maximilian Malfertheiner6, Jacques Creteur3, Alois Philipp7, Fabio Silvio Taccone8, Federico Pappalardo2. 1. Department of Anesthesiology and Intensive Care, University Hospital Regensburg, Regensburg, Germany. 2. Department of Cardiothoracic Anesthesia and Intensive Care, Advanced Heart Failure and Mechanical Circulatory Support Program, San Raffaele Hospital, Vita-Salute University, Milan, Italy. 3. Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Cliniques Universitaires de Bruxelles (CUB) Erasme, Route de Lennik, 808, 1070, Brussels, Belgium. 4. UOS Advanced Respiratory Intensive Care Unit, UOC Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 5. ECMO Centre Karolinska, Karolinska University Hospital, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. 6. Department of Internal Medicine II, Cardiology and Pneumology, Intensive Care, University Medical Center Regensburg, Regensburg, Germany. 7. Department of Perfusion, University Hospital Regensburg, Regensburg, Germany. 8. Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Cliniques Universitaires de Bruxelles (CUB) Erasme, Route de Lennik, 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.
Abstract
PURPOSE: The aim of this study was to assess the neurologic outcome following extracorporeal cardiopulmonary resuscitation (ECPR) in five European centers. METHODS: Retrospective database analysis of prospective observational cohorts of patients undergoing ECPR (January 2012-December 2016) was performed. The primary outcome was 3-month favorable neurologic outcome (FO), defined as the cerebral performance categories of 1-2. Survival to ICU discharge and the number of patients undergoing organ donation were secondary outcomes. A subgroup of patients with stringent selection criteria (i.e., age ≤ 65 years, witnessed bystander CPR, no major co-morbidity and ECMO implemented within 1 h from arrest) was also analyzed. RESULTS: A total of 423 patients treated with ECPR were included (median age 57 [48-65] years; male gender 78%); ECPR was initiated for OHCA in 258 (61%) patients. Time from arrest to ECMO implementation was 65 [48-84] min. Eighty patients (19%) had favorable neurological outcome. ICU survival was 24% (n = 102); 23 (5%) non-survivors underwent organ donation procedures. Favorable neurological outcome rate was lower (9% vs. 34%, p < 0.01) in out-of-hospital than in-hospital cardiac arrest and was significantly associated with shorter time from collapse to ECMO. The application of stringent ECPR criteria (n = 105) resulted in 38% of patients with favorable neurologic outcome. CONCLUSIONS: ECPR was associated with intact neurological recovery in 19% of unselected cardiac arrest victims, with 38% favorable outcome if stringent selection criteria would have been applied.
PURPOSE: The aim of this study was to assess the neurologic outcome following extracorporeal cardiopulmonary resuscitation (ECPR) in five European centers. METHODS: Retrospective database analysis of prospective observational cohorts of patients undergoing ECPR (January 2012-December 2016) was performed. The primary outcome was 3-month favorable neurologic outcome (FO), defined as the cerebral performance categories of 1-2. Survival to ICU discharge and the number of patients undergoing organ donation were secondary outcomes. A subgroup of patients with stringent selection criteria (i.e., age ≤ 65 years, witnessed bystander CPR, no major co-morbidity and ECMO implemented within 1 h from arrest) was also analyzed. RESULTS: A total of 423 patients treated with ECPR were included (median age 57 [48-65] years; male gender 78%); ECPR was initiated for OHCA in 258 (61%) patients. Time from arrest to ECMO implementation was 65 [48-84] min. Eighty patients (19%) had favorable neurological outcome. ICU survival was 24% (n = 102); 23 (5%) non-survivors underwent organ donation procedures. Favorable neurological outcome rate was lower (9% vs. 34%, p < 0.01) in out-of-hospital than in-hospital cardiac arrest and was significantly associated with shorter time from collapse to ECMO. The application of stringent ECPR criteria (n = 105) resulted in 38% of patients with favorable neurologic outcome. CONCLUSIONS: ECPR was associated with intact neurological recovery in 19% of unselected cardiac arrest victims, with 38% favorable outcome if stringent selection criteria would have been applied.
Authors: M Renaudier; Y Binois; F Dumas; L Lamhaut; F Beganton; D Jost; J Charpentier; O Lesieur; E Marijon; X Jouven; A Cariou; W Bougouin Journal: Ann Intensive Care Date: 2022-06-06 Impact factor: 10.318
Authors: Spyros D Mentzelopoulos; Keith Couper; Patrick Van de Voorde; Patrick Druwé; Marieke Blom; Gavin D Perkins; Ileana Lulic; Jana Djakow; Violetta Raffay; Gisela Lilja; Leo Bossaert Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.826
Authors: Arthur S Slutsky; Alain Combes; Daniel Brodie; Darryl Abrams; Graeme MacLaren; Roberto Lorusso; Susanna Price; Demetris Yannopoulos; Leen Vercaemst; Jan Bělohlávek; Fabio S Taccone; Nadia Aissaoui; Kiran Shekar; A Reshad Garan; Nir Uriel; Joseph E Tonna; Jae Seung Jung; Koji Takeda; Yih-Sharng Chen Journal: Intensive Care Med Date: 2021-09-10 Impact factor: 17.440