The Use of ECMO for the Treatment of Refractory Cardiac Arrest or Postarrest Cardiogenic Shock Following In-Hospital Cardiac Arrest: A 10-Year Experience
| Autor: | Andrew D. Althouse, Arthur J. Boujoukos, Meshe Chonde, Robert L. Kormos, Penny L. Sappington |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_treatment Shock Cardiogenic Critical Care and Intensive Care Medicine 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Refractory Extracorporeal membrane oxygenation Humans Medicine Extracorporeal cardiopulmonary resuscitation Registries Aged Retrospective Studies business.industry Cardiogenic shock 030208 emergency & critical care medicine Middle Aged medicine.disease Survival Analysis Heart Arrest Treatment Outcome 030228 respiratory system Anesthesia Female business Follow-Up Studies |
| Zdroj: | Journal of Intensive Care Medicine. 34:615-621 |
| ISSN: | 1525-1489 0885-0666 |
| Popis: | Objectives: Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR. Methods: We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS. Between January 2004 and December 2013, patients were prospectively entered into an institutional registry. One-year follow-up was assessed by electronic medical record or social security death index if clinical follow-up was unavailable. Results: Fifty-one patients were treated with ECMO during the study period. The mean age was 54.0 ± 10.9 years; the majority of patients were men (80.4%). The most common etiology of arrest was acute myocardial infarction (51.0%). Overall, 13 (25.4%) patients survived for at least 1 year. Preexisting coronary artery disease, hypertension, and hyperlipidemia were associated with reduced likelihood of survival. We observed a significant improvement in 1-year mortality in patients treated for PACS when compared to ECPR, 46.7% versus 16.7%, respectively. Conclusion: The use of ECMO for treatment of refractory cardiac arrest or cardiogenic shock may be a suitable treatment in a very select cohort of patients. Our results support a significantly higher 1-year survival in patients with PACS compared to refractory cardiac arrest. |
| Databáze: | OpenAIRE |
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