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KMID : 1100620160030030132
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Clinical and Experimental Emergency Medicine
2016 Volume.3 No. 3 p.132 ~ p.138
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Extracorporeal cardiopulmonary resuscitation among patients with out-of-hospital cardiac arrest
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Choi Dae-Hee
Kim Youn-Jung
Ryoo Seung-Mok
Sohn Chang-Hwan
Ahn Shin
Seo Dong-Woo
Lim Ju-Yong
Kim Won-Young
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Abstract
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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.
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KEYWORD
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Out-of-hospital cardiac arrest, Cardiopulmonary resuscitation, Extracorporeal membrane oxygenation
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