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https://www.readbyqxmd.com/read/30321624/an-integrated-program-of-extracorporeal-membrane-oxygenation-ecmo-assisted-cardiopulmonary-resuscitation-and-uncontrolled-donation-after-circulatory-determination-of-death-in-refractory-cardiac-arrest
#1
Roberto Roncon-Albuquerque, Sérgio Gaião, Paulo Figueiredo, Nuno Príncipe, Carla Basílio, Paulo Mergulhão, Sofia Silva, Teresa Honrado, Francisco Cruz, Manuel Pestana, Gerardo Oliveira, Luis Meira, Ana França, João Paulo Almeida-Sousa, Fernando Araújo, José-Artur Paiva
AIM: To assess the feasibility of an integrated program of extracorporeal cardiopulmonary resuscitation (ECPR) and uncontrolled donation after circulatory determination of death (uDCDD) in refractory cardiac arrest (rCA). METHODS: Single center, prospective, observational study of selected patients with in-hospital (IHCA) and out-of-hospital (OHCA) rCA occurring in an urban area of ∼1.5 million inhabitants, between October-2016 and May-2018. 65 year old or younger patients without significant bleeding or comorbidities with witnessed nonasystolic cardiac arrests were triaged to ECPR if they had a reversible cause and high quality CPR lasting < 60 min...
October 13, 2018: Resuscitation
https://www.readbyqxmd.com/read/29674141/trends-in-utilization-of-mechanical-circulatory-support-in-patients-hospitalized-after-out-of-hospital-cardiac-arrest
#2
Nileshkumar J Patel, Nish Patel, Bhaskar Bhardwaj, Harsh Golwala, Varun Kumar, Varunsiri Atti, Shilpkumar Arora, Smit Patel, Nilay Patel, Gabriel A Hernandez, Apurva Badheka, Carlos E Alfonso, Mauricio G Cohen, Deepak L Bhatt, Navin K Kapur
OBJECTIVE: This study sought to examine the trends and predictors of mechanical circulatory support (MCS) use in patients hospitalized after out-of-hospital cardiac arrest (OHCA). BACKGROUND: There is a paucity of data regarding MCS use in patients hospitalized after OHCA. METHODS: We conducted an observational analysis of MCS use in 960,428 patients hospitalized after OHCA between January 2008 and December 2014 in the Nationwide Inpatient Sample database...
June 2018: Resuscitation
https://www.readbyqxmd.com/read/29626610/health-related-quality-of-life-after-extracorporeal-cardiopulmonary-resuscitation-in-refractory-cardiac-arrest
#3
T Spangenberg, J Schewel, A Dreher, F Meincke, E Bahlmann, H van der Schalk, F Kreidel, C Frerker, M Stoeck, B Bein, K-H Kuck, A Ghanem
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...
June 2018: Resuscitation
https://www.readbyqxmd.com/read/29129499/d-dimer-predicts-bleeding-complication-in-out-of-hospital-cardiac-arrest-resuscitated-with-ecmo
#4
Takayuki Otani, Hirotaka Sawano, Tomoaki Natsukawa, Reiko Matsuoka, Tetsufumi Nakashima, Motonori Takahagi, Yasuyuki Hayashi
PURPOSE: In out-of-hospital cardiac arrest (OHCA) patients resuscitated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), known as extracorporeal cardiopulmonary resuscitation (ECPR), bleeding is a common complication. The purpose of this study was to assess the risk factors for bleeding complications in ECPR patients. METHODS: We retrospectively analyzed the data for OHCA patients admitted to our hospital and resuscitated with ECPR between October 2009 and December 2016...
June 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#5
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
April 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/28915913/neurological-outcomes-and-duration-from-cardiac-arrest-to-the-initiation-of-extracorporeal-membrane-oxygenation-in-patients-with-out-of-hospital-cardiac-arrest-a-retrospective-study
#6
Takahiro Yukawa, Masahiro Kashiura, Kazuhiro Sugiyama, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: We investigated the relationship between neurological outcomes and duration from cardiac arrest (CA) to the initiation of extracorporeal membrane oxygenation (ECMO) (CA-to-ECMO) in patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) and determined the ideal time at which ECPR should be performed. METHODS: During the time period in which this study was conducted, 3451 patients experienced OHCA...
September 16, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28863949/impact-of-rapid-response-car-system-on-ecmo-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#7
Ryota Sato, Akira Kuriyama, Michitaka Nasu, Shinnji Gima, Wataru Iwanaga, Tadaaki Takada, Yusuke Kitahara, Hideto Fukui, Terutake Yonemori, Masaharu Yagi
INTRODUCTION: Extracorporeal life support (ECLS) has been reported to be more effective than conventional cardiopulmonary resuscitation (CPR). In ECLS, a shorter time from arrival to implantation of extracorporeal membrane oxygenation (ECMO; door-to-ECMO) time was predicted to be associated with better survival rates. This study aimed to examine the impact of the physician-based emergency medical services (P-EMS) using a rapid response car (RRC) on door-to-ECMO time in patients with out-of-hospital cardiac arrest (OHCA)...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#8
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
November 2017: CJEM
https://www.readbyqxmd.com/read/28610722/factors-promoting-survival-after-prolonged-resuscitation-attempts-a-case-of-survival-with-good-neurological-outcome-following-60-minutes-of-downtime-after-out-of-hospital-cardiac-arrest
#9
REVIEW
Douglas Bell, Robert Gluer, Dale Murdoch
BACKGROUND: Sudden cardiac arrest is a significant cause of death affecting approximately 25,000 people in Australia annually. METHODS: We present an out-of-hospital cardiac arrest (OHCA) with prolonged down time and recurrent ventricular arrhythmias treated with extra-corporeal membrane oxygenation. RESULTS: The patient survived to hospital discharge with good neurological outcome. CONCLUSION: The patient's excellent outcome was a result of immediate good quality CPR, high level premorbid function, reversible cause of arrest and rapid access to an ECMO centre...
March 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27717334/early-antibiotics-administration-during-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-a-nationwide-database-study
#10
Takashi Tagami, Hiroki Matsui, Masamune Kuno, Yuuta Moroe, Junya Kaneko, Kyoko Unemoto, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Patients resuscitated after cardiac arrest are reportedly at high risk for infection and sepsis, especially those treated with targeted temperature management (TTM). There is, however, limited evidence suggesting that early antibiotic use improves patient outcomes. We examined the hypothesis that early treatment with antibiotics reduces mortality in patients with cardiac arrest receiving TTM. METHODS: We identified 2803 patients with cardiogenic out-of-hospital cardiac arrest (OHCA) that were treated with TTM and were admitted to 371 hospitals that contribute to the Japanese Diagnosis Procedure Combination inpatient database between July 2007 and March 2013...
October 7, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27449821/extracorporeal-membrane-oxygenation-ecmo-assisted-cardiopulmonary-resuscitation-or-uncontrolled-donation-after-the-circulatory-determination-of-death-following-out-of-hospital-refractory-cardiac-arrest-an-ethical-analysis-of-an-unresolved-clinical-dilemma
#11
REVIEW
Anne L Dalle Ave, David M Shaw, Dale Gardiner
BACKGROUND: The availability of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (E-CPR), for use in refractory out-of hospital cardiac arrest (OHCA), is increasing. In parallel, some countries have developed uncontrolled donation after circulatory determination of death (uDCDD) programs using ECMO to preserve organs for transplantation purposes. AIM: When facing a refractory OHCA, how does the medical team choose between initiating ECMO as part of an E-CPR protocol or ECMO as part of a uDCDD protocol? METHODS: To answer these questions we conducted a literature review on E-CPR compared to uDCDD protocols using ECMO and analyzed the raised ethical issues...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27357822/clinical-outcomes-after-rescue-extracorporeal-cardiopulmonary-resuscitation-for-out-of-hospital-cardiac-arrest
#12
Tae Sun Ha, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Chi-Min Park, Kyeongman Jeon, Gee Young Suh
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to have survival benefit in patients who had in-hospital cardiac arrest (IHCA). However, limited data are available on the role of extracorporeal membrane oxygenation (ECMO) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate clinical outcomes and predictors of in-hospital mortality in patients who had OHCA and who underwent ECPR. METHODS: From January 2004 to December 2013, 235 patients who received ECPR were enrolled in a retrospective, single-centre, observational registry...
February 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27318746/emergency-physician-performed-transesophageal-echocardiography-for-extracorporeal-life-support-vascular-cannula-placement
#13
James Fair, Joseph Tonna, Patrick Ockerse, Brian Galovic, Scott Youngquist, Stephen H McKellar, Michael Mallin
INTRODUCTION: There is growing interest and application of extracorporeal membrane oxygenation (ECMO) as a life-saving procedure for out-of-hospital cardiac arrest (OHCA), also called extracorporeal life support (ECLS). Extracorporeal membrane oxygenation cannulation with ongoing chest compressions is challenging, and transesophageal echocardiography (TEE) is an invaluable tool with which to guide ECMO wire guidance and cannula positioning. METHODS: We describe our protocol for TEE guidance by emergency physicians in our hospital...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27193212/out-of-hospital-cardiac-arrest-patients-treated-with-cardiopulmonary-resuscitation-using-extracorporeal-membrane-oxygenation-focus-on-survival-rate-and-neurologic-outcome
#14
Jae Jun Lee, Sang Jin Han, Hyoung Soo Kim, Kyung Soon Hong, Hyun Hee Choi, Kyu Tae Park, Jeong Yeol Seo, Tae Hun Lee, Heung Cheol Kim, Seonju Kim, Sun Hee Lee, Sung Mi Hwang, Sang Ook Ha
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a useful treatment for refractory out-of-hospital cardiac arrest (OHCA). However, little is known about the predictors of survival and neurologic outcome after ECMO. We analyzed our institution's experience with ECMO for refractory OHCA and evaluated the predictors of survival and neurologic outcome after ECMO. METHODS: This was a retrospective review of the medical records of 23 patients who were treated with ECMO due to OHCA that was unresponsive to conventional cardiopulmonary resuscitation, between January 2009 and January 2014...
May 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26509125/comparison-of-extracorporeal-cardiopulmonary-resuscitation-with-conventional-cardiopulmonary-resuscitation-is-extracorporeal-cardiopulmonary-resuscitation-beneficial
#15
Seung-Hun Lee, Jae-Seung Jung, Kwang-Hyung Lee, Hee-Jung Kim, Ho-Sung Son, Kyung Sun
BACKGROUND: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with that of conventional CPR (CCPR)...
October 2015: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25281189/refractory-cardiac-arrest-treated-with-mechanical-cpr-hypothermia-ecmo-and-early-reperfusion-the-cheer-trial
#16
Dion Stub, Stephen Bernard, Vincent Pellegrino, Karen Smith, Tony Walker, Jayne Sheldrake, Lisen Hockings, James Shaw, Stephen J Duffy, Aidan Burrell, Peter Cameron, De Villiers Smit, David M Kaye
INTRODUCTION: Many patients who suffer cardiac arrest do not respond to standard cardiopulmonary resuscitation. There is growing interest in utilizing veno-arterial extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation (E-CPR) in the management of refractory cardiac arrest. We describe our preliminary experiences in establishing an E-CPR program for refractory cardiac arrest in Melbourne, Australia. METHODS: The CHEER trial (mechanical CPR, Hypothermia, ECMO and Early Reperfusion) is a single center, prospective, observational study conducted at The Alfred Hospital...
January 2015: Resuscitation
https://www.readbyqxmd.com/read/24992872/improved-outcome-of-extracorporeal-cardiopulmonary-resuscitation-for-out-of-hospital-cardiac-arrest-a-comparison-with-that-for-extracorporeal-rescue-for-in-hospital-cardiac-arrest
#17
COMPARATIVE STUDY
Chih-Hsien Wang, Nai-Kuan Chou, Lance B Becker, Jou-Wei Lin, Hsi-Yu Yu, Nai-Hsin Chi, Shu-Chien Hunag, Wen-Je Ko, Shoei-Shen Wang, Li-Jung Tseng, Ming-Hsien Lin, I-Hui Wu, Matthew Huei-Ming Ma, Yih-Sharng Chen
PURPOSE: The aim was to investigate the effects of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) and compare the results with those of in-hospital cardiac arrest (IHCA). METHODS: We analyzed our extracorporeal membrane oxygenation (ECMO) results for patients who received ECPR for OHCA or IHCA in the last 5 years. Pre-arrest, resuscitation, and post-resuscitative data were evaluated. RESULTS: In the last 5 years, ECPR was used 230 times for OHCA (n=31) and IHCA (n=199)...
September 2014: Resuscitation
https://www.readbyqxmd.com/read/24785674/extracorporeal-cardiopulmonary-resuscitation
#18
REVIEW
David Fagnoul, Alain Combes, Daniel De Backer
PURPOSE OF REVIEW: To discuss the role of extracorporeal membrane oxygenation (ECMO) in patients with cardiac arrest. RECENT FINDINGS: Return to spontaneous circulation dramatically decreases with the duration of cardiopulmonary resuscitation (CPR). In this context, it has been proposed to implement venoarterial ECMO in order to assist CPR (ECPR) both in inhospital cardiac arrest (IHCA) and in out-of-hospital cardiac arrest (OHCA). SUMMARY: This review highlights that ECPR is feasible for both IHCA and OHCA...
June 2014: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/23816899/extracorporeal-life-support-associated-with-hypothermia-and-normoxemia-in-refractory-cardiac-arrest
#19
David Fagnoul, Fabio Silvio Taccone, Asmae Belhaj, Benoit Rondelet, Jean-Francois Argacha, Jean Louis Vincent, Daniel De Backer
AIM: We describe a 1-year experience with extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) associated with intra-arrest hypothermia and normoxemia. METHODS: Since January 1st 2012, ECPR has been applied in our hospital to all patients less than 65 years of age and without major co-morbidities who develop refractory cardiac arrest (CA) with bystander CPR. Over a 1-year period of observation, we recorded 28-day survival with intact neurological outcome and the rate of organ donation...
November 2013: Resuscitation
https://www.readbyqxmd.com/read/23691782/extracorporeal-life-support-during-cardiac-arrest-resuscitation-in-a-porcine-model-of-ventricular-fibrillation
#20
Joshua C Reynolds, David D Salcido, Matthew L Sundermann, Allison C Koller, James J Menegazzi
Implementation barriers for extracorporeal life support in out-of-hospital cardiac arrest (OHCA) include initiation delay and candidate selection. We explored ischemia duration, cardiopulmonary resuscitation (CPR) duration, and physiologic variables that discriminated animals with return of spontaneous circulation (ROSC). We instrumented eight female swine (31.9 +/- 9.8 kg) with femoral artery and external jugular vein cannula. After 8 (n = 4) or 15 (n = 4) minutes ventricular fibrillation (VF), animals received 30, 40, 50, or 60 minutes of CPR and then drugs (...
March 2013: Journal of Extra-corporeal Technology
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