Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest

Autor: Berthold Bein, Karl-Heinz Kuck, Edda Bahlmann, Felix Meincke, H. van der Schalk, J. Schewel, Christian Frerker, Alexander Ghanem, Tobias Spangenberg, M. Stoeck, A. Dreher, Felix Kreidel
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Resuscitation
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
Emergency Nursing
Statistics
Nonparametric
Extracorporeal
03 medical and health sciences
Extracorporeal Membrane Oxygenation
0302 clinical medicine
Surveys and Questionnaires
Internal medicine
medicine
Extracorporeal membrane oxygenation
Humans
Extracorporeal cardiopulmonary resuscitation
Myocardial infarction
Aged
Retrospective Studies
business.industry
Cardiogenic shock
030208 emergency & critical care medicine
Recovery of Function
Middle Aged
medicine.disease
Cardiopulmonary Resuscitation
humanities
Ventricular fibrillation
Quality of Life
Emergency Medicine
Cardiology
Female
Hemodialysis
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Zdroj: Resuscitation. 127:73-78
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2018.03.036
Popis: Background Recent data identifies extracorporeal cardio-pulmonary resuscitation (eCPR) as a potential addendum of conventional cardiopulmonary-resuscitation (cCPR) in highly specified circumstances and selected patients. However, consented criteria indicating eCPR are lacking. Therefore we provide first insights into the health-related quality of life (HRQoL) outcomes of patients treated with eCPR in a real world setting. Methods Retrospective single-center experience of 60 consecutive patients treated with eCPR between 01/2014 and 06/2016 providing 1-year survival- and HRQoL data obtained through the Short-Form 36 Survey (SF-36) after refractory out-of-hospital- (OHCA) and in-hospital cardiac arrest (IHCA) of presumed cardiac etiology. Results Resuscitation efforts until initiation of eCPR averaged 66 ± 35 min and 63.3% of the patients suffered from OHCA. Fifty-five (91.7%) of the overall events were witnessed and bystander-CPR was performed in 73.3% (n = 44) of cases. Cause of arrest was dominated by acute myocardial infarction (AMI, 66.7%) and initial rhythm slightly outbalanced by ventricular fibrillation/tachycardia (VF/VT 53.3%). 12-month survival was 31%. Survivors experienced more often bystander-CPR (p = .001) and a shorter duration of cCPR (p = .002). While mid-term survivors’ perceived HRQoL was compromised compared to controls (p ≦ .0001 for PF, RP, RE and BP; p = .007 for GH; p = .016 for SF; p = .030 for MH; p = .108 for VT), scores however resembled HRQoL of subjects on hemodialysis, following cardiogenic shock or pulmonary failure treated with extracorporeal membrane oxygenation (ECMO). Conclusions While HRQoL scores of our survivors ranged markedly below controls, compared to patients on chronic hemodialysis, following ECMO for cardiogenic shock or pulmonary failure most of the discrepancies ameliorated. Thus, successfull eCPR in properly selected patients does translate into an encouraging HRQoL approximating chronic renal failure.
Databáze: OpenAIRE
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