Echocardiographic evaluation of cardiac recovery after refractory out-of-hospital cardiac arrest.

Resuscitation
Rajat KalraDemetris Yannopoulos

Abstract

The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. We retrospectively evaluated patients with refractory ventricular tachycardia/ventricular fibrillation out-of-hospital cardiac arrest who were treated with the Minnesota Resuscitation Consortium protocol. Left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), and fractional shortening were assessed using serial echocardiography. One-way analysis of variance (ANOVA) was used to compare parameters over six hospitalization stages. Two-way ANOVA was used to compare these parameters between patients that survived the index hospitalization and those that died. 77 patients had >1 echocardiographic turndown evaluations. Thirty-eight patients survived to discharge and 39 patients died. Of 39 in-hospital deaths, 17 patients died before VA-ECMO decannulation and 22 patients died after VA-ECMO decannulation. Among all patients, LVEF improved from 9.7 ± 10.1% from the first echocardiogram after rewarming to 43.1 ± 1...Continue Reading

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Citations

Feb 5, 2021·Expert Review of Medical Devices·Christopher GaisendreesThorsten Wahlers
Feb 21, 2021·Annals of the New York Academy of Sciences·Tom P AufderheideDemetris Yannopoulos
Jul 27, 2021·Frontiers in Cardiovascular Medicine·Adamantios TsangarisDemetris Yannopoulos

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