PMID: 30153785Aug 30, 2018Paper

Predictors of mortality after extracorporeal cardiopulmonary resuscitation

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Bishoy ZakharyVincent Pellegrino

Abstract

Extracorporeal membrane oxygenation (ECMO) is a promising adjunct to cardiopulmonary resuscitation (CPR) in refractory cardiac arrest (CA). Factors associated with outcome are incompletely characterised. The aim of our study was to identify pre-ECMO factors associated with in-hospital mortality after extracorporeal CPR (ECPR). Retrospective analysis of a prospective cohort of patients. Academic quaternary referral hospital. All patients who underwent ECPR from January 2012 through April 2017. A retrospective chart review was performed for CPR and ECMO. A multivariable logistic regression was performed to identify factors associated with mortality after ECPR. Primary outcome was in-hospital mortality. Secondary outcomes included survival with favourable neurologic outcome, days on ECMO, and intensive care unit (ICU) length of stay. During the study period, 75 patients received ECPR. Median age was 59 years, 81% were male, 51% had out-of-hospital CA, and 57% had an initial shockable rhythm. Median time from arrest to ECMO was 91 minutes (IQR, 56-129) for non-survivors and 51 minutes (IQR, 37-84) for survivors (P =0.02). Twenty-six patients (39%) were successfully separated from ECMO, with 31% surviving to hospital discharge and 2...Continue Reading

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