Eligibility criteria for extracorporeal cardiopulmonary resuscitation at Auckland City Hospital: A retrospective cohort study.
cardiac arrest
extracorporeal cardiopulmonary resuscitation
extracorporeal membranous oxygenation
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
26
05
2020
revised:
07
09
2020
accepted:
11
09
2020
pubmed:
7
10
2020
medline:
19
8
2021
entrez:
6
10
2020
Statut:
ppublish
Résumé
Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising adjunct to routine advanced cardiac life support. Growing worldwide interest in ECPR-use has seen more tertiary centres offering ECPR programmes. New Zealand's nationwide extracorporeal membranous oxygenation service is provided at Auckland City Hospital (ACH). Despite the potential benefits of ECPR, it is currently only offered on an ad hoc basis. It remains unknown whether ACH would manage sufficient numbers of patients to warrant an ECPR programme. A 12-month retrospective cohort study of the medical records of patients who were managed for cardiac arrest in the resuscitation room of the ED was conducted. Patient characteristics and clinical outcomes were analysed descriptively and audited against a unique set of criteria for a hypothetical ECPR programme. Between 1 July 2018 and 30 June 2019, 286 patients died or had a cardiac arrest for which they were managed at ACH. Sixty-five of these patients had an in-hospital cardiac arrest in the ED. Seven (10.8%) of these patients were deemed eligible for hypothetical ECPR. Only one of these seven patients survived to hospital discharge with full neurological recovery. An ECPR programme at ACH using standardised and agreed criteria may benefit a small number of patients and improve rates of survival to hospital discharge with preservation of neurological function. An ECPR guideline would help clarify for referring services cases that are appropriate for extracorporeal membranous oxygenation consideration, rather than discussing on an ad hoc basis.
Identifiants
pubmed: 33021065
doi: 10.1111/1742-6723.13649
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
960-966Subventions
Organisme : Faculty of Medical and Health Sciences, University of Auckland
ID : Summer Research Scholarship 2019
Pays : International
Organisme : National Heart Foundation of New Zealand
ID : Postgraduate Scholarship 2019
Pays : International
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 Australasian College for Emergency Medicine.
Références
Sun T, Guy A, Sidhu A et al. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for emergency cardiac support. J. Crit. Care 2018; 44: 31-8.
Bloch A, Schai N, Friess JO, Merz TM, Erdoes G. ECPR in a tertiary care hospital: presentation of challenges on the basis of a real case. Trends Anaesth. Crit. Care 2018; 21: 27-32.
Ortega-Deballon I, Hornby L, Shemie SD, Bhanji F, Guadagno E. Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes. Resuscitation 2016; 101: 12-20.
Lamhaut L, Jouffroy R, Soldan M et al. Safety and feasibility of prehospital extra corporeal life support implementation by non-surgeons for out-of-hospital refractory cardiac arrest. Resuscitation 2013; 84: 1525-9.
Shinar Z, Plantmason L, Reynolds J et al. Emergency physician-initiated resuscitative extracorporeal membrane oxygenation. J. Emerg. Med. 2019; 56: 666-73.
Laussen PC, Guerguerian AM. Establishing and sustaining an ECPR program. Front. Pediatr. 2018; 6: 1-10.
Lamhaut L, Hutin A, Deutsch J et al. Extracorporeal cardiopulmonary resuscitation (ECPR) in the prehospital setting: an illustrative case of ECPR performed in the louvre museum. Prehosp. Emerg. Care 2017; 21: 386-9.
Yannopoulos D, Bartos JA, Martin C et al. Minnesota resuscitation consortium's advanced perfusion and reperfusion cardiac life support strategy for out-of-hospital refractory ventricular fibrillation. J. Am. Heart Assoc. 2016; 5: e003732.
Stub D, Bernard S, Pellegrino V et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation 2015; 86: 88-94.
Dennis M, Buscher H, Gattas D et al. Prospective observational study of mechanical cardiopulmonary resuscitation, extracorporeal membrane oxygenation and early reperfusion for refractory cardiac arrest in Sydney: the 2CHEER study. Crit. Care Resusc. 2020; 22: 26-34.
Michels G, Wengenmayer T, Hagl C et al. Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR): consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Clin. Res. Cardiol. 2019; 108: 455-64.
Debaty G, Babaz V, Durand M et al. Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest. A systematic review and meta-analysis. Resuscitation 2017; 112: 1-10.
Benchimol EI, Smeeth L, Guttmann A et al. The REporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med. 2015; 12: e1001885.
Recommandations sur les indications de l'assistance circulatoire dans le traitement des arrêts cardiaques réfractaires. Ann. Fr. Anesth. Reanim. 2009; 28: 182-6.
Bermudez CA, McMullan DM. Extracorporeal life support in preoperative and postoperative heart transplant management. Ann. Transl. Med. 2017; 5: 1-6.
Keller SP. Contemporary approaches in the use of extracorporeal membrane oxygenation to support patients waiting for lung transplantation. Ann. Cardiothorac. Surg. 2020; 9: 29-41.
Dicker B, Todd VF, Tunnage B, Swain A, Smith T, Howie G. Direct transport to PCI-capable hospitals after out-of-hospital cardiac arrest in New Zealand: inequities and outcomes. Resuscitation 2019; 142: 111-6.