Lunz, Dirk and Calabro, Lorenzo and Belliato, Mirko and Contri, Enrico and Broman, Lars Mikael and Scandroglio, Anna Maria and Patricio, Daniel and Malfertheiner, Maximilian and Creteur, Jacques and Philipp, Alois and Taccone, Fabio Silvio and Pappalardo, Federico (2020) Extracorporeal membrane oxygenation for refractory cardiac arrest: a retrospective multicenter study. INTENSIVE CARE MEDICINE, 46 (5). pp. 973-982. ISSN 0342-4642, 1432-1238
Full text not available from this repository. (Request a copy)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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIOPULMONARY-RESUSCITATION; LIFE-SUPPORT; SURVIVAL; METAANALYSIS; ASSOCIATION; GUIDELINES; DURATION; DONATION; TRENDS; ADULTS; Cardiac arrest; ECPR; In-hospital; Out-of-hospital; Survival; Neurological outcome |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Mar 2021 10:09 |
| Last Modified: | 30 Mar 2021 10:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45118 |
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