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out-of-hospital ECLS

David Schibilsky, Tobias Kruger, Henning F Lausberg, Christoph Eisenlohr, Christoph Haller, Attila Nemeth, Barbara Schibilsky, Helene Haeberle, Peter Rosenberger, Tobias Walker, Christian Schlensak
The catheter-based Impella 5.0 left ventricular assist device is a powerful and less invasive alternative for patients in cardiogenic shock. The use as second-line therapy in patients with precedent extracorporeal life support (ECLS) has not been described before now. We analyzed our experience of consecutive patients treated with this alternative strategy. From April 2014 to December 2014, eight patients had been implanted as a second-line option after ECLS support. The reason for the change from ECLS to Impella 5...
September 2016: Artificial Organs
N Khodeli, Z Chkhaidze, D Partsakhashvili, O Pilishvili, D Kordzaia
The number of patients who are in the "Transplant Waiting List" is increasing each year. At the same time, as a result of the significant shortage of donor organs, part of the patients dies without waiting till surgery. According to the Maastricht classification for non-heart beating donors, the patients, who had cardiac arrest outside the hospital (in the uncontrolled by medical staff conditions) should be considered as a potential donors of category II. For these patients, the most effective resuscitation is recommended...
May 2016: Georgian Medical News
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
Tobias Spangenberg, Felix Meincke, Stephanie Brooks, Christian Frerker, Felix Kreidel, Thomas Thielsen, Tobias Schmidt, Karl-Heinz Kuck, Alexander Ghanem
OBJECTIVES: The feasibility and outcomes of 35 consecutive patients subjected to eCPR in the tertiary cardiology center were investigated. BACKGROUND: While conventional cardiopulmonary-resuscitation (cCPR) often times achieves only mediocre outcomes extracorporeal cardiopulmonary-resuscitation (eCPR) increasingly shifts into the focus of interest. However, the scientific evidence for eCPR is sparse, particularly in the cardiological setting. METHODS: Retrospective chart analysis of 35 patients treated with eCPR between 01/2014 and 10/2015...
November 2016: Catheterization and Cardiovascular Interventions
Olga Maurin, Benoit Frattini, Daniel Jost, Noémie Galinou, Laure Alhanati, Pascal Dang Minh, Nicolas Genotelle, Guillaume Burlaton, Stanislas de Regloix, Michel Bignand, Jean Pierre Tourtier
INTRODUCTION: During out-of-hospital cardiac arrest (OHCA), chest compression interruptions or hands-off time (HOT) affect the prognosis. Our aim was to measure HOT due to the application of an automated chest compression device (ACD) by an advanced life support team. MATERIALS AND METHODS: This was a prospective observational case series report since the introduction of a new method of installing the ACD. Inclusion criteria were patients over 18 years old with OHCA who were treated with an ACD (Lucas 2(TM), Physio-Control)...
September 2016: Prehospital Emergency Care
Natacha Rousse, Emmanuel Robin, Francis Juthier, Ilir Hysi, Carlo Banfi, Merie Al Ibrahim, Herve Coadou, Patrick Goldstein, Eric Wiel, Andre Vincentelli
Out-of-Hospital refractory Cardiac Arrest (OHrCA) has a mortality rate between 90 and 95%. Since 2009, French medical academic societies have recommended the use of extracorporeal life support (ECLS) for OHrCA. According to these guidelines, patients were eligible for ECLS support if vital signs were still present during cardiopulmonary resuscitation (CPR), or if cardiac arrest was secondary to intoxication or hypothermia (≤32°C). Otherwise, patients would receive ECLS if (i) no-flow duration was less than 5 min; (ii) time delays from CPR to ECLS start (low flow) were less than 100 min; and (iii) expiratory end tidal CO2 (ETCO2 ) was more than 10 mm Hg 20 min after initiating CPR...
September 2016: Artificial Organs
Dong Sun Choi, Taeyun Kim, Young Sun Ro, Ki Ok Ahn, Eui Jung Lee, Seung Sik Hwang, Sung Wook Song, Kyoung Jun Song, Sang Do Shin
BACKGROUND: The benefit of extracorporeal life support (ECLS) in highly selective patients with out-of-hospital cardiac arrest (OHCA) is supported by previous studies; however, it is unclear whether the effects of ECLS are observed at a population level. This study aimed to determine whether ECLS is associated with improved survival outcomes compared to conventional CPR (cardiopulmonary resuscitation) at a national level. METHODS: We used a Korean national OHCA cohort database from 2009 to 2013...
February 2016: Resuscitation
Matteo Pozzi, Catherine Koffel, Xavier Armoiry, Isabelle Pavlakovic, Jean Neidecker, Cyril Prieur, Eric Bonnefoy, Jacques Robin, Jean-François Obadia
BACKGROUND: Cardiopulmonary resuscitation displays low survival rate after out-of-hospital cardiac arrest (OHCA). Extracorporeal life support (ECLS) could be suggested as a rescue therapeutic option in refractory OHCA. The aim of this report is to analyze our experience of ECLS implantation for refractory OHCA. METHODS: We performed a retrospective observational analysis of our prospectively collected database. Patients were divided into a shockable rhythm (SH-R) and a non-shockable rhythm (NSH-R) group according to cardiac rhythm at ECLS implantation...
February 1, 2016: International Journal of Cardiology
Amedeo Anselmi, Erwan Flécher, Hervé Corbineau, Thierry Langanay, Vincent Le Bouquin, Marc Bedossa, Alain Leguerrier, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
OBJECTIVES: Extracorporeal life support (ECLS) is an emerging option to treat selected patients with cardiac arrest refractory to cardiopulmonary resuscitation (CPR). Our primary objective was to determine the mortality at 30 days and at hospital discharge among adult patients receiving veno-arterial ECLS for refractory cardiac arrest. Our secondary objectives were to determine the 1-year survival and the health-related quality of life, and to examine factors associated with 30-day mortality...
October 2015: Journal of Thoracic and Cardiovascular Surgery
Nicolas Deye, Alain Cariou, Patrick Girardie, Nicolas Pichon, Bruno Megarbane, Philippe Midez, Jean-Marie Tonnelier, Thierry Boulain, Hervé Outin, Arnaud Delahaye, Aurélie Cravoisy, Alain Mercat, Pascal Blanc, Charles Santré, Hervé Quintard, François Brivet, Julien Charpentier, Delphine Garrigue, Bruno Francois, Jean-Pierre Quenot, François Vincent, Pierre-Yves Gueugniaud, Jean-Paul Mira, Pierre Carli, Eric Vicaut, Frédéric J Baud
BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest. Whether advanced internal cooling is superior to basic external cooling remains unknown. The aim of this multicenter, controlled trial was to evaluate the benefit of endovascular versus basic surface cooling. METHODS AND RESULTS: Inclusion criteria were the following: age of 18 to 79 years, out-of-hospital cardiac arrest related to a presumed cardiac cause, time to return of spontaneous circulation <60 minutes, delay between return of spontaneous circulation and inclusion <240 minutes, and unconscious patient after return of spontaneous circulation and before the start of cooling...
July 21, 2015: Circulation
James Leatherman
Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma...
June 2015: Chest
Chiara Lazzeri, Serafina Valente, Adriano Peris, Gian Franco Gensini
In recent years, an increasing number of papers have been published on the use of extracorporeal cardiopulmonary resuscitation (ECPR) in adult patients, but, although promising results have been reported in patients with in-hospital refractory cardiac arrest supported by extracorporeal life support (ECLS), data on patients with out-of-hospital (OHCA) cardiac arrest are scarce and conflicting. The present study aims at summarizing the available evidence on the use of ECPR in adult patients with OHCA, clinically focusing on the factors most often associated with outcome in these patients...
December 2016: European Heart Journal. Acute Cardiovascular Care
Michael Poppe, Christoph Weiser, Michael Holzer, Patrick Sulzgruber, Philip Datler, Markus Keferböck, Sebastian Zeiner, Elisabeth Lobmeyr, Raphael van Tulder, Andreas Ziegler, Harald Glück, Manfred Meixner, Georg Schrattenbacher, Henrik Maszar, Andreas Zajicek, Fritz Sterz, Andreas Schober
BACKGROUND: The outcome of patients after out-of-hospital cardiac arrest (OHCA) is poor and gets worse after prolonged resuscitation. Recently introduced attempts like an early installed emergency extracorporeal life support (E-ECLS) in patients with persisting cardiac arrest at the emergency department (ED) are tried. The "Vienna Cardiac Arrest Registry" (VICAR) was introduced August 2013 to collect Utstein-style data. The aim of this observational study was to identify the incidence of patients which fulfil "load&go"-criteria for E-ECLS at the ED...
June 2015: Resuscitation
Bojan Biočina, Mate Petričević, Dražen Belina, Hrvoje Gašparović, Lucija Svetina, Sanja Konosić, Alexandra White, Višnja Ivančan, Tomislav Kopjar, Davor Miličić
AIM: To describe our experience in the clinical application of extracorporeal life support (ECLS) and analyze whether ECLS leads to acceptable clinical outcomes in patients with cardiac failure. METHODS: Data from clinical database of University Hospital Center Zagreb, Croatia, on 75 patients undergoing ECLS support from 2009 to 2014 due to cardiac failure were retrospectively analyzed. Outcomes were defined as procedural and clinical outcomes. ECLS as a primary procedure and ECLS as a postcardiotomy procedure due to inability to wean from cardiopulmonary bypass were analyzed...
December 2014: Croatian Medical Journal
Makbule Nilüfer Öztürk, Koray Ak, Nilgün Erkek, Edanur Yeşıl, Muhterem Duyu, Pınar Yazici, Ayşen Yaprak Engın, Bülent Karapinar
BACKGROUND/AIM: Extracorporeal membrane oxygenation (ECMO) is a unique life-support modality offered to patients unresponsive to optimal medical therapy. The aim of this study was to evaluate early experiences with ECMO support in 2 tertiary Turkish pediatric intensive care units (PICUs). MATERIALS AND METHODS: We retrospectively evaluated a total of 10 ECMO-supported patients between March 2012 and March 2013 in Marmara and Ege University Hospital PICUs. We reported data regarding demographics, laboratory and diagnostic information, and the clinical course of the patients...
2014: Turkish Journal of Medical Sciences
R Jouffroy, L Lamhaut, A Guyard, P Phillipe, T Deluze, M Jaffry, C Dagron, W Bourgoin, J P Orsini, K An, X Jouven, C Spaulding, P Carli
OBJECTIVE: To examine whether values of arterial base excess or lactate taken 3 h after starting ECLS indicate poor prognosis and if this can be used as a screening tool to follow Extra Corporeal Life Support after Out Hospital Cardiac Arrest due to acute coronary syndrome. DESIGN: Single Centre retrospective observational study. SETTING: University teaching hospital general adult intensive care unit. PATIENTS: 15 consecutive patients admitted to the intensive care unit after refractory Out Hospital Cardiac Arrest due to acute coronary syndrome treated by Extra Corporeal Life Support...
December 2014: Resuscitation
Nicholas J Johnson, Michael Acker, Cindy H Hsu, Nimesh Desai, Prashanth Vallabhajosyula, Sofiane Lazar, Jiri Horak, Joyce Wald, Fenton McCarthy, Eduardo Rame, Kathryn Gray, Sarah M Perman, Lance Becker, Doreen Cowie, Anne Grossestreuer, Tom Smith, David F Gaieski
BACKGROUND: Extracorporeal life support (ECLS) has been utilized as a rescue strategy for patients with cardiac arrest unresponsive to conventional cardiopulmonary resuscitation. OBJECTIVE: We sought to describe our institution's experience with implementation of ECLS for out-of-hospital and emergency department (ED) cardiac arrests. Our primary outcome was survival to hospital discharge. METHODS: Consecutive patients placed on ECLS in the ED or within one hour of admission after out-of-hospital or ED cardiac arrest were enrolled at two urban academic medical centers in the United States from July 2007-April 2014...
November 2014: Resuscitation
Gabriel Putzer, Birgit Mair, Herbert Hangler, Mathias Ströhle, Peter Mair
No abstract text is available yet for this article.
August 2014: Journal of Cardiothoracic and Vascular Anesthesia
Samuel A Tisherman
PURPOSE OF REVIEW: Survival from traumatic cardiac arrest is associated with a very high mortality despite aggressive resuscitation including an Emergency Department thoracotomy (EDT). Novel salvage techniques are needed to improve these outcomes. RECENT FINDINGS: More aggressive out-of-hospital interventions, such as chest decompression or thoracotomy by emergency physicians or anesthesiologists, seem feasible and show some promise for improving outcomes. For trauma patients who suffer severe respiratory failure or refractory cardiac arrest, there seems to be an increasing role for the use of extracorporeal life support (ECLS), utilizing heparin-bonded systems to avoid systemic anticoagulation...
December 2013: Current Opinion in Critical Care
Lionel Lamhaut, Romain Jouffroy, Michaela Soldan, Pascal Phillipe, Thibaut Deluze, Murielle Jaffry, Christelle Dagron, Benoit Vivien, Christian Spaulding, Kim An, Pierre Carli
BACKGROUND: Extra corporeal life support (ECLS) has been recently introduced in the treatment of refractory cardiac arrest (CA). Several studies have assessed the use of ECLS in refractory CA once the patients reach hospital. The time between CA and the implementation of ECLS is a major prognostic factor for survival. The main predictive factor for survival is ECLS access time. Pre hospital ECLS implementation could reduce access time. We therefore decided to assess the feasibility and safety of prehospital ECLS implementation (PH-ECLS) in a pilot study...
November 2013: Resuscitation
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