Christopher Gaisendrees1, Sebastian Walter2, Anton Sabashnikov2, Christoph Adler3, Thorsten Wahlers2. 1. Herzzentrum, Klinik und Poliklinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland. Christopher.gaisendrees@uk-koeln.de. 2. Herzzentrum, Klinik und Poliklinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland. 3. Herzzentrum, Klinik III für Innere Medizin, Allgemeine und interventionelle Kardiologie, Elektrophysiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Universitätsklinikum Köln, Köln, Deutschland.
Abstract
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) affects ca. 75,000 people each year in Germany and is associated with a limited prognosis and a high mortality. Extracorporeal cardiopulmonary resuscitation (eCPR) using arteriovenous extracorporeal membrane oxygenation (av-ECMO) systems is an additional option for treatment, which is increasingly more widespread and since 2020 anchored in the guideline algorithm. METHODS: A selective search of the literature was carried out in PubMed and Embase focusing on studies that investigated eCPR for OHCA. Furthermore, clinical studies on this topic that are currently recruiting and running are summarized. RESULTS: The available data on the benefits of eCPR for OHCA are mostly based on retrospective cohort studies. A survival advantage and an advantage in the neurological outcome could be derived from these data for selected patients treated with eCPR vs. conventionally resuscitated patients (CPR). This effect could be confirmed by two current randomized controlled studies. Studies which are currently running are investigating if out-of-hospital ECMO cannulation at the earliest time possible at the site of OHCA of patients could be associated with a better survival. CONCLUSION: Despite a current scarcity of data, a survival advantage for eCPR treatment in selected OHCA patients must be assumed. If this can be substantiated by other high-quality studies, it seems to be indicated to evaluate if and to what extent resource-intensive eCPR programs can be comprehensively established.
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) affects ca. 75,000 people each year in Germany and is associated with a limited prognosis and a high mortality. Extracorporeal cardiopulmonary resuscitation (eCPR) using arteriovenous extracorporeal membrane oxygenation (av-ECMO) systems is an additional option for treatment, which is increasingly more widespread and since 2020 anchored in the guideline algorithm. METHODS: A selective search of the literature was carried out in PubMed and Embase focusing on studies that investigated eCPR for OHCA. Furthermore, clinical studies on this topic that are currently recruiting and running are summarized. RESULTS: The available data on the benefits of eCPR for OHCA are mostly based on retrospective cohort studies. A survival advantage and an advantage in the neurological outcome could be derived from these data for selected patients treated with eCPR vs. conventionally resuscitated patients (CPR). This effect could be confirmed by two current randomized controlled studies. Studies which are currently running are investigating if out-of-hospital ECMO cannulation at the earliest time possible at the site of OHCA of patients could be associated with a better survival. CONCLUSION: Despite a current scarcity of data, a survival advantage for eCPR treatment in selected OHCA patients must be assumed. If this can be substantiated by other high-quality studies, it seems to be indicated to evaluate if and to what extent resource-intensive eCPR programs can be comprehensively established.
Authors: Tom P Aufderheide; Rajat Kalra; Marinos Kosmopoulos; Jason A Bartos; Demetris Yannopoulos Journal: Ann N Y Acad Sci Date: 2021-02-20 Impact factor: 5.691
Authors: Xavier Bemtgen; Jonathan Rilinger; Markus Jäckel; Viviane Zotzmann; Alexander Supady; Christoph Benk; Christoph Bode; Tobias Wengenmayer; Achim Lother; Dawid L Staudacher Journal: Clin Res Cardiol Date: 2021-05-04 Impact factor: 5.460