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Affiliation
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Adult and Pediatric Critical Care, University of Pittsburgh School of Medicine, United States; Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, United States; Vascular Medicine Institute, University of Pittsburgh School of Medicine, United States. |
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Abstract
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Extracorporeal cardiopulmonary resuscitation (E-CPR) has been used successfully for decades in selected cases of cardiac arrest. In a seminal study on this topic, del Nido et al. 1
reported on its use in children for in-hospital arrests after cardiac surgery over 20 years ago. Recently, there has been a veritable explosion in interest in and publication on E-CPR including applications after both out-of-hospital and in-hospital arrests. This year alone there have already been reports on at least 60 patients treated with E-CPR in this journal.
Recent reports, such as the CHEER trial, where application of mechanical CPR, therapeutic hypothermia, extracorporeal membrane oxygenation, and early reperfusion have been used have yielded impressive outcomes such as survival to hospital discharge with full neurological recovery in as many as 54% of patients.
Similarly Bednarczyk et al. reported on 32 patients treated with E-CPR for arrest refractory to CPR and found 45.4% 30 day survival – with all patients recovering to cerebral performance category (CPC) 1–2. Last year, Shin et al. reported on a large cohort of 85 E-CPR cases where it was applied in the setting of in-hospital arrest in adults and noted a 25.5% 2-year survival with minimal neurological impairment – greatly outpacing a 5.9% rate observed in a propensity matched conventional CPR group. It is noteworthy, however, that somewhat less optimistic results have been recently reported by others specifically in the setting of out-of-hospital cardiac arrest CA.
Language: en |