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out-of-hospital ECLS

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https://www.readbyqxmd.com/read/28877346/comparable-outcome-of-out-of-hospital-cardiac-arrest-and-in-hospital-cardiac-arrest-treated-with-extracorporeal-life-support
#1
Omar Ellouze, Melitine Vuillet, Justine Perrot, Sandrine Grosjean, Anis Missaoui, Serge Aho, Ghislain Malapert, Belaid Bouhemad, Oliver Bouchot, Claude Girard
Extracorporeal life support (ECLS) has shown benefits in the management of refractory in-hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out-of-hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single-center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality...
September 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28863949/impact-of-rapid-response-car-system-on-extracorporeal-life-support-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#2
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)...
August 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28838358/coronary-artery-disease-in-patients-with%C3%A2-out-of-hospital-refractory-ventricular-fibrillation-cardiac-arrest
#3
MULTICENTER STUDY
Demetris Yannopoulos, Jason A Bartos, Ganesh Raveendran, Marc Conterato, Ralph J Frascone, Alexander Trembley, Ranjit John, John Connett, David G Benditt, Keith G Lurie, Robert F Wilson, Tom P Aufderheide
BACKGROUND: The prevalence of coronary artery disease (CAD) among patients with refractory out-of-hospital (OH) ventricular fibrillation (VF)/ventricular tachycardia (VT) cardiac arrest is unknown. OBJECTIVES: The goal of this study was to describe the prevalence and complexity of CAD and report survival to hospital discharge in patients experiencing refractory VF/VT cardiac arrest treated with a novel protocol of early transport to a cardiac catheterization laboratory (CCL) for extracorporeal life support (ECLS) and revascularization...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28682938/improving-patient-selection-for-refractory-out-of-hospital-cardiac-arrest-treated-with-extracorporeal-life-support
#4
Tahar Chouihed, Antoine Kimmoun, Adrien Lauvray, Francois-Xavier Laithier, Deborah Jaeger, Simon Lemoine, Juan Pablo Maureira, Lionel Nace, Kevin Duarte, Stéphane Albizzati, Nicolas Girerd, Bruno Levy
BACKGROUND: Despite recent management improvement, including Extra-Corporeal Life Support (ECLS), refractory out-of-hospital cardiac arrest (ROHCA) survival remains dramatically low. METHODS: We assessed an innovative strategy (Out of hoSpital Cardiac ARrest-ExtraCorporeal Life Support - "OSCAR-ECLS") to optimize access to ECLS of ROHCA patients and reduce the delay between recognition and ECLS implantation. METHODS: This study, conducted in a tertiary teaching hospital, compared the survival and delay times of ROHCA patients treated by ECLS before and after OSCAR-ECLS implementation...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28432023/pulmonary-embolism-related-sudden-cardiac-arrest-admitted-alive-at-hospital-management-and-outcomes
#5
Wulfran Bougouin, Eloi Marijon, Benjamin Planquette, Nicole Karam, Florence Dumas, David S Celermajer, Daniel Jost, Lionel Lamhaut, Frankie Beganton, Alain Cariou, Guy Meyer, Xavier Jouven
AIM: Pulmonary Embolism (PE) is a relatively common cardiovascular condition, occasionally and tragically manifesting as Sudden Cardiac Arrest (SCA). The natural history of SCA complicating PE has been poorly evaluated.In this study, we described the management and outcome of PE-related SCA. METHODS: In this prospective population--based study, we included all patients admitted at hospital alive after out- of- hospital SCA, in Paris and suburbs, France (6.6 million inhabits), from May 2011 to September 2015...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#6
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27645397/impella-5-0-as-a-second-line-mechanical-circulatory-support-strategy-after-extracorporeal-life-support
#7
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
https://www.readbyqxmd.com/read/27348175/-theoretical-background-of-finding-organs-for-transplantation-among-non-heart-beating-donors-under-unsuccessful-extracorporeal-resuscitation-literature-review
#8
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
https://www.readbyqxmd.com/read/27318746/emergency-physician-performed-transesophageal-echocardiography-for-extracorporeal-life-support-vascular-cannula-placement
#9
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/27315227/-shock-and-go-extracorporeal-cardio-pulmonary-resuscitation-in-the-golden-hour-of-rosc
#10
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
https://www.readbyqxmd.com/read/27018547/hands-off-time-during-automated-chest-compression-device-application-in-out-of-hospital-cardiac-arrest-a-case-series-report
#11
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
https://www.readbyqxmd.com/read/26684540/extracorporeal-life-support-in-out-of-hospital-refractory-cardiac-arrest
#12
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
https://www.readbyqxmd.com/read/26683472/extracorporeal-life-support-and-survival-after-out-of-hospital-cardiac-arrest-in-a-nationwide-registry-a-propensity-score-matched-analysis
#13
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/26655543/extracorporeal-life-support-for-refractory-out-of-hospital-cardiac-arrest-should-we-still-fight-for-a-single-centre-5-year-experience
#14
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
https://www.readbyqxmd.com/read/26189164/survival-and-quality-of-life-after-extracorporeal-life-support-for-refractory-cardiac-arrest-a-case-series
#15
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
https://www.readbyqxmd.com/read/26092673/endovascular-versus-external-targeted-temperature-management-for-patients-with-out-of-hospital-cardiac-arrest-a-randomized-controlled-study
#16
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26033128/mechanical-ventilation-for-severe-asthma
#17
REVIEW
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
https://www.readbyqxmd.com/read/25969550/editor-s-choice-extracorporeal-life-support-for-out-of-hospital-cardiac-arrest-part-of-a-treatment-bundle
#18
REVIEW
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
https://www.readbyqxmd.com/read/25779007/the-incidence-of-load-go-out-of-hospital-cardiac-arrest-candidates-for-emergency-department-utilization-of-emergency-extracorporeal-life-support-a-one-year-review
#19
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
https://www.readbyqxmd.com/read/25559831/results-of-extracorporeal-life-support-implementation-in-routine-clinical-practice-single-center-experience
#20
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
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