Author:
Chandru Pramod,Mitra Tatum Priyambada,Dhanekula Nitesh Dutt,Dennis Mark,Eslick Adam,Kruit Natalie,Coggins Andrew
Abstract
AbstractBackgroundRefractory out of hospital cardiac arrest (OHCA) is associated with extremely poor outcomes. However, in selected patients extracorporeal cardiopulmonary resuscitation (eCPR) may be an effective rescue therapy, allowing time treat reversible causes. The primary goal was to estimate the potential future caseload of eCPR at historically 'low-volume' extracorporeal membrane oxygenation (ECMO) centres.MethodsA 3-year observational study of OHCA presenting to the Emergency Department (ED of an urban referral centre without historical protocolised use of eCPR. Demographics and standard Utstein outcomes are reported. Further, an a priori analysis of each case for potential eCPR eligibility was conducted. A current eCPR selection criteria (from the 2-CHEER study) was used to determine eligibly.ResultsIn the study window 248 eligible cardiac arrest cases were included in the OHCA registry. 30-day survival was 23.4% (n = 58). The mean age of survivors was 55.4 years. 17 (6.8%) cases were deemed true refractory arrests and fulfilled the 2-CHEER eligibility criteria. The majority of these cases presented within “office hours” and no case obtained a return of spontaneous circulation standard advanced life support.ConclusionsIn this contemporary OHCA registry a significant number of refractory cases were deemed potential eCPR candidates reflecting a need for future interdisciplinary work to support delivery of this therapy.
Publisher
Springer Science and Business Media LLC
Reference31 articles.
1. Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015;86:88–94.
2. Cheung W, Middleton P, Davies S, Tummala S, Thanakrishnan G, Gullick J. A comparison of survival following out-of-hospital cardiac arrest in Sydney, Australia, between 2004–2005 and 2009–2010. Crit Care Resusc. 2013;15(3):241.
3. Zive DM, Schmicker R, Daya M, Kudenchuk P, Nichol G, Rittenberger JC, et al. Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium. Resuscitation. 2018;131:74–82.
4. Eisenburger P, Havel C, Sterz F, Uray T, Zeiner A, Haugk M, et al. Transport with ongoing cardiopulmonary resuscitation may not be futile. Br J Anaesth. 2008;101(4):518–22.
5. Morrison LJ, Visentin LM, Kiss A, Theriault R, Eby D, Vermeulen M, et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2006;355(5):478–87.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献