Vassili Panagides1,2,3, Henrik Vase4, Sachin P Shah5, Mir B Basir6, Julien Mancini7, Hayaan Kamran5, Supria Batra5, Marc Laine1,2,3, Hans Eiskjær4, Steffen Christensen8, Mina Karami9, Franck Paganelli1,2,3, Jose P S Henriques9, Laurent Bonello1,2,3. 1. Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France. 2. Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13015 Marseille, France. 3. Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, 13015 Marseille, France. 4. Department of Cardiology, Aarhus University Hospital, 8200 Aarhus, Denmark. 5. Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA 01805, USA. 6. Department of Cardiology, Henry Ford Hospital, Detroit, MI 48202, USA. 7. Department of Public Health (BIOSTIC), Aix-Marseille University, INSERM, IRD, APHM, UMR1252, SESSTIM, Hôpital de la Timone, 13005 Marseille, France. 8. Department of Intensive Care Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark. 9. Department of Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1081 HV Amsterdam, The Netherlands.
Abstract
BACKGROUND: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. METHODS: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. RESULTS: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). CONCLUSIONS: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.
BACKGROUND: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. METHODS: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. RESULTS: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). CONCLUSIONS: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.
Authors: Demetris Yannopoulos; Jason A Bartos; Ganesh Raveendran; Marc Conterato; Ralph J Frascone; Alexander Trembley; Ranjit John; John Connett; David G Benditt; Keith G Lurie; Robert F Wilson; Tom P Aufderheide Journal: J Am Coll Cardiol Date: 2017-08-29 Impact factor: 24.094