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https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#1
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#2
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#3
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28125963/effect-of-ultrasonography-and-fluoroscopic-guidance-on-the-incidence-of-complications-of-cannulation-in-extracorporeal-cardiopulmonary-resuscitation-in-out-of-hospital-cardiac-arrest-a-retrospective-observational-study
#4
Masahiro Kashiura, Kazuhiro Sugiyama, Takahiro Tanabe, Akiko Akashi, Yuichi Hamabe
BACKGROUND: It remains unclear which cannulation method is best in cases of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest. We assessed the effect of ultrasound- and fluoroscopy-guided percutaneous cannulation on complication incidence, compared with that using only ultrasound guidance. METHODS: This single-center retrospective observational study was conducted between February 2011 and December 2015. In the comparison group, cannulation was performed percutaneously using only ultrasound guidance...
January 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28123613/comparison-of-extracorporeal-and-conventional-cardiopulmonary-resuscitation-a-meta-analysis-of-2-260-patients-with-cardiac-arrest
#5
Gan-Nan Wang, Xu-Feng Chen, Li Qiao, Yong Mei, Jin-Ru Lv, Xi-Hua Huang, Bin Shen, Jin-Song Zhang
BACKGROUND: This meta-analysis aimed to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients with cardiac arrest (CA). DATA RESOURCES: PubMed, EMBASE, Web of Science, and China Biological Medicine Database were searched for relevant articles. The baseline information and outcome data (survival, good neurological outcome at discharge, at 3-6 months, and at 1 year after CA) were collected and extracted by two authors...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28122916/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#6
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 25, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28118848/the-association-of-findings-on-brain-computed-tomography-with-neurologic-outcomes-following-extracorporeal-cardiopulmonary-resuscitation
#7
Jeong-Am Ryu, Chi Ryang Chung, Yang Hyun Cho, Kiick Sung, Gee Young Suh, Taek Kyu Park, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Seung-Hyuk Choi, Jeong Hoon Yang
BACKGROUND: Limited data are available on imaging predictors of neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). We investigated the association of initial brain computed tomography (CT) findings with neurological outcomes following ECPR. METHODS: Between February 2005 and December 2015, a total of 42 patients who underwent brain CT scans within 48 h after ECPR were analyzed. Loss of the boundary between gray matter and white matter (LOB) or cortical sulcal effacement (SE), gray-to-white matter ratio (GWR), and optic nerve sheath diameter (ONSD) were measured on initial brain CT...
January 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28114337/association-between-body-temperature-patterns-and-neurological-outcomes-after-extracorporeal-cardiopulmonary-resuscitation
#8
Jeong-Am Ryu, Taek Kyu Park, Chi Ryang Chung, Yang Hyun Cho, Kiick Sung, Gee Young Suh, Tae Rim Lee, Min Seob Sim, Jeong Hoon Yang
We evaluated the association of body temperature patterns with neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). Between December 2013 and December 2015, we enrolled 48 patients with cardiac arrest who survived for at least 24 hours after ECPR. Based on their body temperature patterns and the intention to control fever, we divided the patients into those in whom fever was actively controlled (N = 25), those with normothermia (N = 17), and those with unintended hypothermia (N = 6)...
2017: PloS One
https://www.readbyqxmd.com/read/28108436/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#9
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28103127/extracorporeal-cardiopulmonary-resuscitation-ecpr-in-the-prehospital-setting-an-illustrative-case-of-ecpr-performed-in-the-louvre-museum
#10
Lionel Lamhaut, Alice Hutin, Juliette Deutsch, Jean-Herlé Raphalen, Romain Jouffroy, Jean-Pierre Orsini, Frédéric Baud, Pierre Carli
INTRODUCTION: Extracorporeal Cardiopulmonary Resuscitation (ECPR) is now considered for the treatment of refractory cardiac arrest. CASE REPORT: In an urban city like Paris, extraction times of in-hospital ECPR can be long for patients presenting with refractory cardiac arrest. Using the medicalized prehospital system, we developed a possible early prehospital ECPR implementation. This case report is an example of ECPR prehospital implementation in the Louvre Museum...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28093811/routine-use-of-distal-arterial-perfusion-in-pediatric-femoral-venoarterial-extracorporeal-membrane-oxygenation
#11
Christine A Schad, Brian P Fallon, Julie Monteagudo, Shunpei Okochi, Eva W Cheung, Nicholas J Morrissey, Angela V Kadenhe-Chiweshe, Gudrun Aspelund, Steven Stylianos, William Middlesworth
Lower-extremity ischemia is a significant complication in children on femoral venoarterial extracorporeal membrane oxygenation (VA ECMO). Our institution currently routinely uses distal perfusion catheters (DPCs) in all femoral arterial cannulations in attempts to reduce ischemia. We performed a single-center, retrospective review of pediatric patients supported with femoral VA ECMO from January 2005 to November 2015. The outcomes of patients with prophylactic DPC placement at cannulation (prophylactic DPC) were compared to a historical group with DPCs placed in response only to clinically evident ischemic changes (reactive DPC)...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#12
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28045013/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-in-children-after-cardiac-surgery
#13
Ersin Erek, Selim Aydın, Dilek Suzan, Okan Yıldız, Fırat Altın, Barış Kırat, Ibrahim Halil Demir, Ender Ödemiş
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitation; ECPR) unresponsive to conventional methods. In this study, the results of ECPR in a cardiac arrest setting after cardiac surgery in children were analyzed. METHODS: In this retrospective cohort study, between November 2010 and June 2014, 613 congenital heart operations were performed by the same surgical team...
March 3, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28007740/early-coronary-reperfusion-facilitates-return-of-spontaneous-circulation-and-improves-cardiovascular-outcomes-after-ischemic-cardiac-arrest-and-extracorporeal-resuscitation-in-pigs
#14
Alice Hutin, Lionel Lamhaut, Fanny Lidouren, Matthias Kohlhauer, Nicolas Mongardon, Pierre Carli, Alain Berdeaux, Bijan Ghaleh, Renaud Tissier
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is widely proposed for the treatment of refractory cardiac arrest. It should be associated with coronary angiography if coronary artery disease is suspected. However, the prioritization of care remains unclear in this situation. Our goal was to determine whether coronary reperfusion should be instituted as soon as possible in such situations in a pig model. METHODS AND RESULTS: Anesthetized pigs were instrumented and submitted to coronary artery occlusion and ventricular fibrillation...
December 22, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28007504/prognostic-factors-for-extracorporeal-cardiopulmonary-resuscitation-recipients-following-out-of-hospital-refractory-cardiac-arrest-a-systematic-review-and-meta-analysis
#15
REVIEW
Guillaume Debaty, Valentin Babaz, Michel Durand, Lucie Gaide-Chevronnay, Emmanuel Fournel, Marc Blancher, Hélène Bouvaist, Olivier Chavanon, Maxime Maignan, Pierre Bouzat, Pierre Albaladejo, José Labarère
PURPOSE: Association estimates between baseline characteristics and outcomes are imprecise and inconsistent among extracorporeal cardiopulmonary resuscitation (ECPR) recipients following refractory out-of-hospital cardiac arrest (OHCA). This systematic review and meta-analysis aimed to investigate the prognostic significance of pre-specified characteristics for OHCA treated with ECPR. METHODS: The Medline electronic database was searched via PubMed for articles published from January 2000 to September 2016...
December 19, 2016: Resuscitation
https://www.readbyqxmd.com/read/27993632/ecmo-cardio-pulmonary-resuscitation-ecpr-trends-in-survival-from-an-international-multicentre-cohort-study-over-12-years
#16
Alexander Sacha C Richardson, Matthieu Schmidt, Michael Bailey, Vincent A Pellegrino, Peter T Rycus, David V Pilcher
BACKGROUND: Use of Extracorporeal Membrane Oxygenation during cardiopulmonary resuscitation (ECPR) is increasingly being deployed as an adjunct to conventional CPR. It is unknown if this has been associated with improved outcomes. AIMS: To describe trends in survival and patient demographics for ECPR patients in the international Extracorporeal Life Support Organisation (ELSO) database over the past 12 years and identify factors associated with changes in survival...
March 2017: Resuscitation
https://www.readbyqxmd.com/read/27986281/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-a-multicentre-experience
#17
Mark Dennis, Peter McCanny, Mario D'Souza, Paul Forrest, Brian Burns, David A Lowe, David Gattas, Sean Scott, Paul Bannon, Emily Granger, Roger Pye, Richard Totaro
AIM: To describe the ECPR experience of two Australian ECMO centres, with regards to survival and neurological outcome, their predictors and complications. METHODS: Retrospective observational study of prospectively collected data on all patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) at two academic ECMO referral centres in Sydney, Australia. MEASUREMENTS AND MAIN RESULTS: Thirty-seven patients underwent ECPR, 25 (68%) were for in-hospital cardiac arrests...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27984315/effect-of-pulsatility-on-microcirculation-in-patients-treated-with-extracorporeal-cardiopulmonary-resuscitation-a-pilot-study
#18
Petra Krupičková, Michal Huptych, Zuzana Mormanová, Tomáš Bouček, Tomáš Belza, Ondřej Šmíd, Aleš Král, Hana Skalická, Aleš Linhart, Jan Bělohlávek
The effect of pulsatile blood flow on microcirculation during extracorporeal cardiopulmonary resuscitation (ECPR) is not elucidated, therefore we designed an observational study comparing sublingual microcirculation in refractory cardiac arrest patients with spontaneously pulsatile or low/non-pulsatile blood flow following treatment with ECPR. Microcirculation was assessed with Sidestream Dark Field technology in 12 cardiac arrest patients treated with ECPR and 12 healthy controls. Microcirculatory images were analyzed offline in a blinded fashion and consensual parameters were determined for the vessels ≤ 20 μm...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27968964/-evolution-of-the-nurse-s-role-in-the-management-of-a-cardiac-arrest
#19
Florian Loosli, Alice Hutin, Hugues Lefort, Pierre Carli, Lionel Lamhaut
In France, there are 40 000 sudden deaths each year and the cardiac arrest survival rate is less than 10%. The arrival of extracorporeal cardio pulmonary resuscitation (ECPR) offers hope in the event of refractory cardiac arrest in prehospital care. Extending ECPR programmes requires more scientific evidence, training and an evolution of the role of paramedics.
November 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/27935015/extracorporeal-cardiopulmonary-resuscitation-after-out-of-hospital-cardiac-arrest-in-a-danish-health-region
#20
J Fjølner, J Greisen, M R S Jørgensen, C J Terkelsen, L B Ilkjaer, T M Hansen, H Eiskjaer, S Christensen, J Gjedsted
BACKGROUND: Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region...
February 2017: Acta Anaesthesiologica Scandinavica
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