Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review

2020 ◽  
Author(s):  
Paweł Podsiadło ◽  
Tomasz Darocha ◽  
Øyvind S. Svendsen ◽  
Sylweriusz Kosiński ◽  
Tom Silfvast ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support

scholarly journals Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis

2016 ◽  
Vol 42 (12) ◽  
pp. 1922-1934 ◽  
Author(s):  
Dagmar M. Ouweneel ◽  
Jasper V. Schotborgh ◽  
Jacqueline Limpens ◽  
Krischan D. Sjauw ◽  
A. E. Engström ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Meta Analysis

scholarly journals Rewarming From Hypothermic Cardiac Arrest Applying Extracorporeal Life Support: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Lars J. Bjertnæs ◽  
Kristian Hindberg ◽  
Torvind O. Næsheim ◽  
Evgeny V. Suborov ◽  
Eirik Reierth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Body Temperature ◽  
Hospital Discharge ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Meta Analysis ◽  
Low Ph ◽  
Individual Data ◽  
Male Sex

Introduction: This systematic review and meta-analysis aims at comparing outcomes of rewarming after accidental hypothermic cardiac arrest (HCA) with cardiopulmonary bypass (CPB) or/and extracorporeal membrane oxygenation (ECMO).Material and Methods: Literature searches were limited to references with an abstract in English, French or German. Additionally, we searched reference lists of included papers. Primary outcome was survival to hospital discharge. We assessed neurological outcome, differences in relative risks (RR) of surviving, as related to the applied rewarming technique, sex, asphyxia, and witnessed or unwitnessed HCA. We calculated hypothermia outcome prediction probability score after extracorporeal life support (HOPE) in patients in whom we found individual data. P < 0.05 considered significant.Results: Twenty-three case observation studies comprising 464 patients were included in a meta-analysis comparing outcomes of rewarming with CPB or/and ECMO. One-hundred-and-seventy-two patients (37%) survived to hospital discharge, 76 of 245 (31%) after CPB and 96 of 219 (44 %) after ECMO; 87 and 75%, respectively, had good neurological outcomes. Overall chance of surviving was 41% higher (P = 0.005) with ECMO as compared with CPB. A man and a woman had 46% (P = 0.043) and 31% (P = 0.115) higher chance, respectively, of surviving with ECMO as compared with CPB. Avalanche victims had the lowest chance of surviving, followed by drowning and people losing consciousness in cold environments. Assessed by logistic regression, asphyxia, unwitnessed HCA, male sex, high initial body temperature, low pH and high serum potassium (s-K+) levels were associated with reduced chance of surviving. In patients displaying individual data, overall mean predictive surviving probability (HOPE score; n = 134) was 33.9 ± 33.6% with no significant difference between ECMO and CPB-treated patients. We also surveyed 80 case reports with 96 victims of HCA, who underwent resuscitation with CPB or ECMO, without including them in the meta-analysis.Conclusions: The chance of surviving was significantly higher after rewarming with ECMO, as compared to CPB, and in patients with witnessed compared to unwitnessed HCA. Avalanche victims had the lowest probability of surviving. Male sex, high initial body temperature, low pH, and high s-K+ were factors associated with low surviving chances.

scholarly journals TCT-128 A systematic review and meta-analysis of extracorporeal life support during cardiac arrest and cardiogenic shock

2016 ◽  
Vol 68 (18) ◽  
pp. B52
Author(s):  
Dagmar M. Ouweneel ◽  
Jasper Schotborgh ◽  
Jaqueline Limpens ◽  
Krischan Sjauw ◽  
Annemarie Engstrom ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Meta Analysis

Survival and Factors Associated with Survival with Extracorporeal Life Support During Cardiac Arrest

ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Vassili Panagides ◽  
Marc Laine ◽  
Guillaume Fond ◽  
Guillaume Lebreton ◽  
Franck Paganelli ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Factors Associated

scholarly journals Reply to: The role of extracorporeal life support in patients with hypothermic cardiac arrest

Resuscitation ◽  
2019 ◽  
Vol 134 ◽  
pp. 159-160
Author(s):  
Michael M. Beyea ◽  
Bourke W. Tillmann ◽  
A. Dave Nagpal
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support

scholarly journals Survival and quality of life after extracorporeal life support for refractory cardiac arrest: A case series

2015 ◽  
Vol 150 (4) ◽  
pp. 947-954 ◽  
Author(s):  
Amedeo Anselmi ◽  
Erwan Flécher ◽  
Hervé Corbineau ◽  
Thierry Langanay ◽  
Vincent Le Bouquin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Series ◽  
Refractory Cardiac Arrest

Abstract 19091: Prognosis of Patients With Out-of-hospital Refractory Cardiac Arrest Referred for Extracorporeal Life Support: An Observational Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Cecile Ursat ◽  
Marie-Ange Tilliette ◽  
Charles Groizard ◽  
Margot Cassuto ◽  
Anna Ozguler ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Spontaneous Circulation ◽  
Flow Time ◽  
Low Flow ◽  
Time Interval ◽  
Specific Situation ◽  
Time Intervals ◽  
Paris Area

Introduction: In case of no return of spontaneous circulation (ROSC) after conventional cardio-pulmonary resuscitation (CPR), out-of-hospital cardiac arrest (OHCA) patients could be referred for extracorporeal life support (ECLS). Guidelines have been published concerning this specific situation (1). The aim of our study was to describe the prognosis of OHCA patients and verify if referral to ECLS was compliant with these recommendations mainly studying time intervals (no-flow < 5 min, low-flow < 100 min). Methods: A prospective survey on OHCA referred to ECLS was implemented from 03/01/12 until 06/11/15 in an Emergency Medical Service (EMS) located in Paris area (France). This survey included 43 patients referred to hospital for ECLS. Variables were given as means and percentages. Results: Patients referred to ECLS were more often men (77%), with a mean age of 51 years old. Most of 43 OHCA occurred at home (51%), although 26% occurred on public area and 16% at workplace. In 40% of cases, CPR was performed by a witness and in 33% by a health professional. A first Basic Life Support ambulance arrived on scene within 7 min 50 sec, whereas EMS ambulance arrived on scene within 18 min 27 sec after OHCA. At EMS arrival on scene, patients were on asystole (44%), ventricular fibrillation (37%), and on spontaneous circulation (12%). The no-flow time interval was 4 min 10 sec on average (6 patients had a no-flow over 5 min) with 43% of patients with no no-flow. Low-flow time-interval was 44 min. External electric shock was delivered before EMS arrival on 21% of cases, and EMS itself delivered a shock in 40% of cases. Epinephrine was used for all patients, 10.35 mg on average. No patient survived OHCA after referral to ECLS. Discussion: Although this is a small series of 43 patients, no OHCA patient referred to ECLS survived. These results are mainly due to a non-shockable initial condition or too long no-flow time intervals. In order to improve the outcome and bring benefit to the proper expected patients through a cost-effective pathway, we released a reminder of the right recommendations in our EMS. (1) Riou B., Adnet F., Baud F et al. A. Recommandation sur les indications de l’assistance circulatoire dans le traitement des arrêts cardiaques réfractaires. Ann Fr Anesth Réanim 2009 ; 28 : 182-6.

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