Extracorporeal cardiopulmonary resuscitation among patients with out-of-hospital cardiac arrest

• Published in: Clinical and experimental emergency medicine Vol. 3; no. 3; pp. 132 - 138
• Main Authors: Choi, Dae-Hee, Kim, Youn-Jung, Ryoo, Seung Mok, Sohn, Chang Hwan, Ahn, Shin, Seo, Dong-Woo, Lim, Ju Yong, Kim, Won Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Emergency Medicine 01.09.2016; 대한응급의학회
• Subjects: cardiopulmonary resuscitation; extracorporeal membrane oxygenation; Original; out-of-hospital cardiac arrest; 응급의학; Out-of-hospital cardiac arrest; Extracorporeal membrane oxygenation; Cardiopulmonary resuscitation
• ISSN: 2383-4625; 2383-4625
• DOI: 10.15441/ceem.16.145

Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered as a rescue therapy for patients with refractory cardiac arrest. Identifying patients who might benefit from this potential life-saving procedure is crucial for implementation of ECPR. The objective of this study was to estimate the number of patients who fulfilled a hypothetical set of ECPR criteria and to evaluate the outcome of ECPR candidates treated with conventional cardiopulmonary resuscitation. We performed an observational study using data from a prospective registry of consecutive adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest in a tertiary hospital between January 2011 and December 2015. We developed a hypothetical set of ECPR criteria including age ≤75 years, witnessed cardiac arrest, no-flow time ≤5 minutes, low-flow time ≤30 minutes, refractory arrest at emergency department >10 minutes, and no exclusion criteria. The primary endpoint was the proportion of good neurologic outcome of ECPR-eligible patients. Of 568 out-of-hospital cardiac arrest cases, 60 cases (10.6%) fulfilled our ECPR criteria. ECPR was performed for 10 of 60 ECPR-eligible patients (16.7%). Three of the 10 patients with ECPR (30.0%), but only 2 of the other 50 patients without ECPR (4.0%) had a good neurologic outcome at 1 month. ECPR implementation might be a rescue option for increasing the probability of survival in potentially hopeless but ECPR-eligible patients.