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. 2021 Oct;36(10):3528-3539.
doi: 10.1111/jocs.15804. Epub 2021 Jul 11.

Outcomes of adult patients supported by extracorporeal membrane oxygenation (ECMO) following cardiopulmonary arrest. The Mayo Clinic experience

Pramod K Guru  1 , Troy G Seelhammer  2 , Tarun D Singh  2 , Devang K Sanghavi  1 , Sanjay Chaudhary  1 , Jeffrey B Riley  3 , Tammy Friedrich  4 , John M Stulak  3 , Dawit T Haile  2 , Rahul Kashyap  2 , Gregory J Schears  2
Affiliations

Outcomes of adult patients supported by extracorporeal membrane oxygenation (ECMO) following cardiopulmonary arrest. The Mayo Clinic experience

Pramod K Guru et al. J Card Surg. 2021 Oct.

Abstract

Introduction: To describe our experience in use of extracorporeal life support (ECLS) as a rescue strategy in patients following cardiopulmonary resuscitation.

Methods: A retrospective analysis was performed for patients (n = 101) who received ECLS after cardiorespiratory arrest between May 2001 and December 2014. The primary outcome was survival to hospital discharge.

Results: In this cohort median (IQR) age was 56 (37-67) years, 53 (53%) were male, and 90 (89%) were Caucasian. Ventricular tachycardia or ventricular fibrillations were the initial cardiac rhythm in 49 (48.5%) and asystole/pulseless electrical activity in 37 (36.8%). Median (IQR) time to initiation of extracorporeal support from arrest time was 72 (43-170) min. The median (IQR) duration of support was 100 (47-157) hours. Renal failure (66%) and bleeding (66%) were the two most commonly observed complications during ECLS support. The survival to hospital discharge was seen in 47 (47%) patients, and good neurologic outcome (mRs 0-3) was seen in 29%. Acidosis, lactate and continuous renal replacement therapy were independent predictors of mortality. The median (IQR) intensive care unit stay was 14 (4-28) days and hospital stay was 17 (4-35) days.

Conclusion: Our institutional experience with ECLS as a rescue measure following cardiac arrest is associated with improvement in mortality, and favorable neurologic status at hospital discharge.

Keywords: ECMO; ECPR; VAECMO; cardiac arrest; ecls; resuscitation.

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References

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