Background: Cardiopulmonary resuscitation displays low survival rate after out-of-hospital cardiac arrest (OHCA). Extracorporeal life support (ECLS) could be suggested as a rescue therapeutic option in refractory OHCA. The aim of this report is to analyze our experience of ECLS implantation for refractory OHCA.
Methods: We performed a retrospective observational analysis of our prospectively collected database. Patients were divided into a shockable rhythm (SH-R) and a non-shockable rhythm (NSH-R) group according to cardiac rhythm at ECLS implantation. The primary endpoint was survival to hospital discharge with good neurological recovery.
Results: From January 2010 to December 2014 we used ECLS in 68 patients (SH-R, n=19, 27.9% vs. NSH-R, n=49, 72.1%) for refractory OHCA. The clinical profile before ECLS implantation was comparable between the groups. Eight (11.7%) patients were successfully weaned from ECLS (SH-R=31.5% vs. NSH-R=4.0%, p=0.01) after a mean period of support of 2.1 days (SH-R=4.1 days vs. NSH-R=1.4 days, p=0.01). Six (8.8%) patients survived to discharge (SH-R=31.5% vs. NSH-R=0%, p=0.00). In the SH-R group 50% of the survivors were discharged without neurological complications.
Conclusions: ECLS for refractory OHCA should be limited in consideration of its poor, especially neurological, outcome. Non-shockable rhythms could be considered as a formal contraindication allowing a concentration of our efforts on the shockable rhythms, where the chances of success are substantial.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2015.11.165 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Revascularization During Cardiac Arrest While Receiving Extracorporeal Life Support in Patients With Acute Myocardial Infarction.
JACC Adv
January 2025
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
Article Synopsis
- ECPR has enabled previously ineligible patients with refractory out-of-hospital cardiac arrest (OHCA) from acute myocardial infarction (AMI) to undergo primary percutaneous coronary intervention (PCI).
- A study examined 671 patients over five years, finding that 37% of them had refractory cardiac arrest despite ECPR, with about 65% achieving return of spontaneous circulation (ROSC) post-PCI and 21% surviving to discharge.
- Key factors influencing survival included having prehospital ROSC, quicker ECPR initiation, and achieving a high TIMI flow grade after the procedure.
Long-term heart function in refractory out-of-hospital cardiac arrest treated with prehospital extracorporeal cardiopulmonary resuscitation.
Resuscitation
November 2024
SAMU de Paris and Intensive Care Unit, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris 75015, France; Paris Sudden Death Expertise Center, Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris 75015, France; Paris Cité University, Paris, France.
Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on heart function in surviving patients remains unclear.
Methods: We conducted a 9 year monocentric retrospective observational study in Paris, France (January 1, 2015, to December 31, 2023).
Survival in relation to number of defibrillation attempts in out-of-hospital cardiac arrest.
Resuscitation
December 2024
Center for Resuscitation Science, Department of Clinical Science and Education, Södersjukhuset (KI SÖS), Karolinska Institute, Stockholm, Sweden. Electronic address:
Article Synopsis
- The study investigates the survival rates of out-of-hospital cardiac arrest (OHCA) patients with shockable rhythms in relation to the number of defibrillations they received.
- It analyzed data from 10,549 patients in Sweden over a decade, finding that survival rates decreased significantly with each additional defibrillation.
- The results indicate that patients receiving more shocks had lower 30-day survival probabilities, suggesting that after a certain point, additional defibrillations may not be beneficial.
The relationship between race and emergency medical services resuscitation intensity for those in refractory-arrest.
Resusc Plus
December 2024
British Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada.
Background: Previous studies have reported race-based health disparities in North America. It is unknown if emergency medical service (EMS) treatment of out-of-hospital cardiac arrest (OHCA) varies based on race. We sought to compare markers of resuscitation intensity among different racial groups.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how extracorporeal membrane oxygenation (ECMO) and percutaneous coronary interventions (PCI) affect the restoration of organized heart rhythms in patients experiencing out-of-hospital cardiac arrest (OHCA) with refractory shockable rhythms.
- Of 289 patients analyzed, 51% achieved an organized rhythm through advanced cardiac life support before reaching the hospital, while 30% did so after ECMO but before PCI, and only 13% did so after PCI.
- Patients with obstructive coronary artery disease had better outcomes when they achieved an organized rhythm before PCI, indicating that early effective treatment is critical for better neurological survival.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!