Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience.

Impella cardiac arrest cardiopulmonary resuscitation hemodynamic support device refractory cardiac arrest

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
18 Jan 2021
Historique:
received: 20 12 2020
revised: 08 01 2021
accepted: 15 01 2021
entrez: 22 1 2021
pubmed: 23 1 2021
medline: 23 1 2021
Statut: epublish

Résumé

Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min ( In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

Sections du résumé

BACKGROUND BACKGROUND
Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown.
METHODS METHODS
We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival.
RESULTS RESULTS
Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (
CONCLUSIONS CONCLUSIONS
In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

Identifiants

pubmed: 33477532
pii: jcm10020339
doi: 10.3390/jcm10020339
pmc: PMC7831079
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Resuscitation. 2017 Mar;112:1-10
pubmed: 28007504
Heart Lung Circ. 2017 Aug;26(8):e37-e40
pubmed: 28291665
Ann Fr Anesth Reanim. 2009 Feb;28(2):182-90
pubmed: 19232884
ASAIO J. 2011 May-Jun;57(3):169-76
pubmed: 21317769
JACC Cardiovasc Interv. 2019 Sep 23;12(18):1840-1849
pubmed: 31537284
Intensive Care Med. 2007 Feb;33(2):237-45
pubmed: 17019558
Anaesth Crit Care Pain Med. 2018 Jun;37(3):195-196
pubmed: 29578079
Resuscitation. 2015 Feb;87:e11
pubmed: 25498473
Resuscitation. 2019 Jul;140:178-184
pubmed: 31009694
J Am Coll Cardiol. 2017 Aug 29;70(9):1109-1117
pubmed: 28838358
Eur Heart J. 2015 May 21;36(20):1223-30
pubmed: 25732762
Ann Thorac Surg. 2019 Mar;107(3):809-816
pubmed: 30365965
Eur Heart J Acute Cardiovasc Care. 2020 Mar;9(2):164-172
pubmed: 31353918
Resuscitation. 2017 Mar;112:70-74
pubmed: 27751862
Resuscitation. 2010 Nov;81(11):1479-87
pubmed: 20828914
Ann Thorac Surg. 2014 Feb;97(2):610-6
pubmed: 24210621
Int J Cardiol. 2016 Dec 15;225:111-112
pubmed: 27718442
Circulation. 2019 Jan 15;139(3):337-346
pubmed: 30586728
Crit Care. 2018 Sep 29;22(1):242
pubmed: 30268147
Resuscitation. 2016 Aug;105:188-95
pubmed: 27321577
Resuscitation. 2017 Aug;117:109-117
pubmed: 28414164
Am J Respir Crit Care Med. 2015 Apr 15;191(8):894-901
pubmed: 25695688
Resuscitation. 2016 Apr;101:12-20
pubmed: 26836946
Intensive Care Med. 2016 Dec;42(12):1922-1934
pubmed: 27647331
Resuscitation. 2016 Feb;99:26-32
pubmed: 26683472
Crit Care. 2011;15(1):R29
pubmed: 21244674
Circ Res. 2015 Jun 5;116(12):2041-9
pubmed: 26044255
Circ J. 2020 Jun 25;84(7):1097-1104
pubmed: 32522902
Crit Care. 2017 Jun 22;21(1):157
pubmed: 28637497
Resuscitation. 2017 Dec;121:62-70
pubmed: 29020604

Auteurs

Vassili Panagides (V)

Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France.
Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13015 Marseille, France.
Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, 13015 Marseille, France.

Henrik Vase (H)

Department of Cardiology, Aarhus University Hospital, 8200 Aarhus, Denmark.

Sachin P Shah (SP)

Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA 01805, USA.

Mir B Basir (MB)

Department of Cardiology, Henry Ford Hospital, Detroit, MI 48202, USA.

Julien Mancini (J)

Department of Public Health (BIOSTIC), Aix-Marseille University, INSERM, IRD, APHM, UMR1252, SESSTIM, Hôpital de la Timone, 13005 Marseille, France.

Hayaan Kamran (H)

Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA 01805, USA.

Supria Batra (S)

Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA 01805, USA.

Marc Laine (M)

Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France.
Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13015 Marseille, France.
Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, 13015 Marseille, France.

Hans Eiskjær (H)

Department of Cardiology, Aarhus University Hospital, 8200 Aarhus, Denmark.

Steffen Christensen (S)

Department of Intensive Care Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark.

Mina Karami (M)

Department of Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1081 HV Amsterdam, The Netherlands.

Franck Paganelli (F)

Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France.
Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13015 Marseille, France.
Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, 13015 Marseille, France.

Jose P S Henriques (JPS)

Department of Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1081 HV Amsterdam, The Netherlands.

Laurent Bonello (L)

Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France.
Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), 13015 Marseille, France.
Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, 13015 Marseille, France.

Classifications MeSH