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Dae-Hee Choi, Youn-Jung Kim, Seung Mok Ryoo, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Ju Yong Lim, Won Young Kim
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered as a rescue therapy for patients with refractory cardiac arrest. Identifying patients who might benefit from this potential life-saving procedure is crucial for implementation of ECPR. The objective of this study was to estimate the number of patients who fulfilled a hypothetical set of ECPR criteria and to evaluate the outcome of ECPR candidates treated with conventional cardiopulmonary resuscitation. METHODS: We performed an observational study using data from a prospective registry of consecutive adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest in a tertiary hospital between January 2011 and December 2015...
September 2016: Clin Exp Emerg Med
C Wallmüller, P Stratil, A Schober
The development of technical assist devices in the context of cardiopulmonary resuscitation (CPR) reaches back to the early roots of modern resuscitation research. This article covers the subjects of extracorporeal CPR (ECPR), including extracorporeal life support (ECLS), emergency ECLS (EECLS) and mechanical resuscitation devices. Specifically, the potential use of active compression-decompression CPR (ACD-CPR), impedance threshold devices (ITD) and capnography as additional measures during resuscitation are described in detail...
October 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Chiwon Ahn, Wonhee Kim, Youngsuk Cho, Kyu-Sun Choi, Bo-Hyoung Jang, Tae Ho Lim
We performed a meta-analysis to compare the impact of extracorporeal cardiopulmonary resuscitation (ECPR) to that of conventional cardiopulmonary resuscitation (CCPR) in adult patients who experience cardiac arrest of cardiac origin. A literature search was performed using criteria set forth in a predefined protocol. Report inclusion criteria were that ECPR was compared to CCPR in adult patients with cardiac arrest of cardiac origin, and that survival and neurological outcome data were available. Exclusion criteria were reports describing non-cardiac origin arrest, review articles, editorials, and nonhuman studies...
2016: Scientific Reports
Joseph E Tonna, Nicholas J Johnson, John Greenwood, David F Gaieski, Zachary Shinar, Joseph M Bellezo, Lance Becker, Atman P Shah, Scott T Youngquist, Michael P Mallin, James Franklin Fair, Kyle J Gunnerson, Cindy Weng, Stephen McKellar
PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO)...
October 2016: Resuscitation
Michael A Mazzeffi, Pablo G Sanchez, Daniel Herr, Eric Krause, Charles F Evans, Raymond Rector, Brian McCormick, Si Pham, Bradley Taylor, Bartley Griffith, Zachary N Kon
BACKGROUND: The role of extracorporeal cardiopulmonary resuscitation (ECPR) in adult cardiac surgery patients with refractory cardiac arrest is uncertain. We hypothesized that ECPR would be associated with better than expected outcomes in this group of patients. METHODS: We conducted a single-center retrospective cohort study of adult cardiac surgery patients who underwent ECPR for refractory cardiac arrest during a 6-year period (2010 to 2015). In-hospital mortality, survival at last follow-up, and cerebral performance category (CPC) were examined as outcomes, and potential risk factors for mortality were explored...
October 2016: Journal of Thoracic and Cardiovascular Surgery
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...
June 29, 2016: Emergency Medicine Journal: EMJ
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...
June 17, 2016: Catheterization and Cardiovascular Interventions
Hong Ju Shin, Seunghwan Song, Han Ki Park, Young Hwan Park
BACKGROUND: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. METHODS: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. RESULTS: Twelve children, median age 6...
June 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Itumeleng C Taunyane, Christoph Benk, Friedhelm Beyersdorf, Katharina Foerster, Heidi Cristina Schmitz, Karin Wittmann, Irina Mader, Soroush Doostkam, Claudia Heilmann, Georg Trummer
OBJECTIVES: Clinical outcomes following cardiac arrest (CA) and resuscitation remain a cause for concern. The use of Controlled Automated Reperfusion of the whoLe body (CARL) confers superior neurological outcome even after extended periods of CA. We aimed at investigating clinical outcome and brain morphology preservation when employing CARL following CA periods of 20 min. METHODS: Twenty-eight pigs were allocated to four extracorporeal circulation treatment strategies; seven others served as magnetic resonance imaging (MRI) controls...
June 3, 2016: European Journal of Cardio-thoracic Surgery
Christopher R Burke, Titus Chan, Thomas V Brogan, Laurance Lequier, Ravi R Thiagarajan, Peter T Rycus, D Michael McMullan
AIM: Unintentional drowning is a significant public health concern in the United States and represents a leading cause of death in the pediatric population. Extracorporeal life support (ECLS) may be used to support drowning victims, but outcomes have not been well defined. This study examined survival rates and risk factors for death in this population. METHODS: Retrospective data from the Extracorporeal Life Support Organization registry was examined to determine outcomes of ECLS and risk factors for death in drowning victims...
July 2016: Resuscitation
Brian Grunau, Joshua Reynolds, Frank Scheuermeyer, Robert Stenstom, Dion Stub, Sarah Pennington, Sheldon Cheskes, Krishnan Ramanathan, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may improve outcomes for refractory out-of-hospital cardiac arrest (OHCA). Transport of intra-arrest patients to hospital however, may decrease CPR quality, potentially reducing survival for those who would have achieved return-of-spontaneous-circulation (ROSC) with further on-scene resuscitation. We examined time-to-ROSC and patient outcomes for the optimal time to consider transport. METHODS: From a prospective registry of consecutive adult non-traumatic OHCA's, we identified a hypothetical ECPR-eligible cohort of EMS-treated patients with age ≤ 65, witnessed arrest, and bystander CPR or EMS arrival < 10 minutes...
September 2016: Prehospital Emergency Care
Alexandrine Brunner, Natacha Dubois, Peter C Rimensberger, Oliver Karam
To improve survival rates during CPR, some patients are put on extracorporeal membrane oxygenation (ECMO). Among children who have undergone ECMO cardiopulmonary resuscitation (ECPR), the overall rate of survival to discharge is close to 40%. However, despite its wide acceptance and use, the appropriate indications and organizational requirements for ECPR have yet to be defined. Our objective was to assess the clinical outcomes of children after ECPR and to determine pre-ECPR prognostic factors for survival to guide its indication...
2016: Critical Care Research and Practice
Cynthia Ocegueda-Pacheco, Joseph Varon
No abstract text is available yet for this article.
June 2016: Resuscitation
Brian Grunau, Frank Xavier Scheuermeyer, Dion Stub, Robert H Boone, Joseph Finkler, Sarah Pennington, Sarah Ann Carriere, Anson Cheung, Ruth MacRedmond, Jamil Bashir, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR), while resource-intensive, may improve outcomes in selected patients with refractory out-of-hospital cardiac arrest (OHCA). We sought to identify patients who fulfilled a set of ECPR criteria in order to estimate: (1) the proportion of patients with refractory cardiac arrest who may have benefited from ECPR; and (2) the outcomes achieved with conventional resuscitation. METHODS: We performed a secondary analysis from a 52-month prospective registry of consecutive adult non-traumatic OHCA cases from a single urban Canadian health region serving one million patients...
March 4, 2016: CJEM
Su Jin Kim, Hyun Jung Kim, Hee Young Lee, Hyeong Sik Ahn, Sung Woo Lee
INTRODUCTION: The objective was to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), when compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients, and to determine appropriate conditions that can predict good survival outcome in ECPR patients through a meta-analysis. METHODS: We searched the relevant literature of comparative studies between ECPR and CCPR in adults, from the MEDLINE, EMBASE, and Cochrane databases...
June 2016: Resuscitation
Iván Ortega-Deballon, Laura Hornby, Sam D Shemie, Farhan Bhanji, Elena Guadagno
AIM: Extracorporeal resuscitation during cardiopulmonary resuscitation (ECPR) deploys rapid cardiopulmonary bypass to sustain oxygenated circulation until the return of spontaneous circulation (ROSC). The purpose of this systematic review is to address the defining elements and outcomes (quality survival and organ donation) of currently active protocols for ECPR in refractory out-of-hospital cardiac arrest (OHCA) of cardiac origin in adult patients. The results may inform policy and practices for ECPR and help clarify the corrresponding intersection with deceased organ donation...
April 2016: Resuscitation
Tomoki Yamada, Tetsuhisa Kitamura, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Megumi Ishiro, Toshifumi Uejima, Yasuo Ohishi, Kazuhisa Kaneda, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Tetsuro Nishimura, Yasuyuki Hayashi, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tasuku Matsuyama, Takashi Kawamura, Takeshi Shimazu, Taku Iwami
BACKGROUND: We established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including percutaneous coronary intervention (PCI), target temperature management, and extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients. METHODS: In Osaka Prefecture, Japan, we registered all consecutive patients who were suffering from an OHCA for whom resuscitation was attempted and who were then transported to institutions participating in this registry since July 1, 2012...
2016: Journal of Intensive Care
Young Hwan Lee, Young Taeck Oh, Hee Cheol Ahn, Hyoung Soo Kim, Sang Jin Han, Jae Jun Lee, Tae Hun Lee, Jeong Yeol Seo, Dong Hyuk Shin, Sang Ook Ha, Sang O Park
AIM: The grey-to-white matter ratio (GWR) is a reliable predictor of the neurological outcome of out-of-hospital cardiac arrest (OHCA). However, the reliability in patients receiving extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) remains unknown. We evaluated the utility of the GWR in predicting neurological outcomes in ECPR-treated patients. METHODS: This single-centre retrospective study was conducted from July 2009 to January 2014...
February 2016: Resuscitation
Derk Pannen, Maria Fabisch, Lisa Gausling, Karin Schnetz
The Rcs phosphorelay is a two-component signal transduction system that is induced by cell envelope stress. RcsB, the response regulator of this signaling system, is a pleiotropic transcription regulator, which is involved in the control of various stress responses, cell division, motility, and biofilm formation. RcsB regulates transcription either as a homodimer or together with auxiliary regulators, such as RcsA, BglJ, and GadE in Escherichia coli. In this study, we show that RcsB in addition forms heterodimers with MatA (also known as EcpR) and with DctR...
January 29, 2016: Journal of Biological Chemistry
Eunmi Gil, Jeong Hoon Yang, Jeongwon Heo, M I Kyoung Hong, Chi Ryang Chung, Chi-Min Park, Gee Young Suh
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
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