Extracorporeal cardiopulmonary resuscitation among patients with out-of-hospital cardiac arrest
최대희, 김윤정, 유승목, 손창환, 안신, 서동우, Lim Ju-Yong, 김원영,
소속 상세정보
최대희 ( Choi Dae-Hee )
University of Ulsan College of Medicine Department of Emergency Medicine
김윤정 ( Kim Youn-Jung )
University of Ulsan College of Medicine Department of Emergency Medicine
유승목 ( Ryoo Seung-Mok )
University of Ulsan College of Medicine Asan Medical Center Department of Emergency Medicine
손창환 ( Sohn Chang-Hwan )
University of Ulsan College of Medicine Asan Medical Center Department of Emergency Medicine
안신 ( Ahn Shin )
University of Ulsan College of Medicine Department of Emergency Medicine
서동우 ( Seo Dong-Woo )
University of Ulsan College of Medicine Department of Emergency Medicine
( Lim Ju-Yong )
University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
김원영 ( Kim Won-Young )
University of Ulsan College of Medicine Department of Emergency Medicine
KMID : 1100620160030030132
Abstract
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. We developed a hypothetical set of ECPR criteria including age ≤75 years, witnessed cardiac arrest, no-flow time ≤5 minutes, low-flow time ≤30 minutes, refractory arrest at emergency department >10 minutes, and no exclusion criteria. The primary endpoint was the proportion of good neurologic outcome of ECPR-eligible patients.
Results:Of 568 out-of-hospital cardiac arrest cases, 60 cases (10.6%) fulfilled our ECPR criteria. ECPR was performed for 10 of 60 ECPR-eligible patients (16.7%). Three of the 10 patients with ECPR (30.0%), but only 2 of the other 50 patients without ECPR (4.0%) had a good neurologic outcome at 1 month.
Conclusion:ECPR implementation might be a rescue option for increasing the probability of survival in potentially hopeless but ECPR-eligible patients.
키워드
Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation
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