TY - JOUR
T1 - Extracorporeal membrane oxygenation for refractory cardiac arrest
T2 - a retrospective multicenter study
AU - Lunz, Dirk
AU - Calabrò, Lorenzo
AU - Belliato, Mirko
AU - Contri, Enrico
AU - Broman, Lars Mikael
AU - Scandroglio, Anna Maria
AU - Patricio, Daniel
AU - Malfertheiner, Maximilian
AU - Creteur, Jacques
AU - Philipp, Alois
AU - Taccone, Fabio Silvio
AU - Pappalardo, Federico
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - Cardiac arrest
KW - ECPR
KW - In-hospital
KW - Neurological outcome
KW - Out-of-hospital
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85079416281&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079416281&partnerID=8YFLogxK
U2 - 10.1007/s00134-020-05926-6
DO - 10.1007/s00134-020-05926-6
M3 - Article
C2 - 32052069
AN - SCOPUS:85079416281
JO - Intensive Care Medicine
JF - Intensive Care Medicine
SN - 0342-4642
ER -