Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: A prospective observational study

Sakamoto, Tetsuya; Morimura, Naoto; Nagao, Ken; Asai, Yasufumi; Yokota, Hiroyuki; Nara, Satoshi; Hase, Mamoru; Terada, Yoshio; Atsumi, Takahiro

doi:10.1016/j.resuscitation.2014.01.031

Cited by 462 publications

(375 citation statements)

References 22 publications

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“…There were no published randomized controlled trials (RCTs) although two (NCT01511666 and NCT01605409) are currently enrolling patients in Prague and Vienna. 10,11 Four of the selected studies were conducted in Japan, 2 in Korea and 1 in Taiwan, [12][13][14][15][16][17][18] 5 in France, 19-23 2 in Germany 24,25 and 2 in Italy. 26,27 The remaining case series and reports were from Belgium, 28 Austria, 29 USA 30 and Australia.…”

Section: Ecpr Studiesmentioning

confidence: 99%

“…Maekawa et al 13 and Kim et al 12 performed a post hoc analysis of a prospective observational study, LOE 3. Sakamoto et al 16 completed a large prospective observational study (LOE 2) which is the strongest level of evidence identified. Most of the included studies presented high risk of confounding bias and threats to external validity because of their observational design.…”

Section: Ecpr Studiesmentioning

confidence: 99%

“…Most of the included studies presented high risk of confounding bias and threats to external validity because of their observational design. However, the methodological quality assessment of the 20 included studies resulted in a rating of good for 14 studies [12][13][14][15][16]18,20,[22][23][24][25][26][27][28] and fair for the other 6 17,19,21,29-31 (see Table 1). …”

Section: Ecpr Studiesmentioning

confidence: 99%

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Shapiro

Josephson

Rosenfeld³

et al. 2017

Annals ATS

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a b s t r a c tAim: Extracorporeal resuscitation during cardiopulmonary resuscitation (ECPR) deploys rapid cardiopulmonary bypass to sustain oxygenated circulation until the return of spontaneous circulation (ROSC). The purpose of this systematic review is to address the defining elements and outcomes (quality survival and organ donation) of currently active protocols for ECPR in refractory out-of-hospital cardiac arrest (OHCA) of cardiac origin in adult patients. The results may inform policy and practices for ECPR and help clarify the corrresponding intersection with deceased organ donation. Methods: We searched Medline, Embase, Cochrane and seven other electronic databases from 2005 to 2015, with no language restrictions. Internal validity and the quality of the studies reporting outcomes and guidelines were assessed. The review was included in the international prospective register of systematic reviews (Prospero, CRD42014015259). Results: One guideline and 20 outcome studies were analyzed. Half of the studies were prospective observational studies assessed to be of fair to good methodological quality. The remainder were retrospective cohorts, case series, and case studies. Ages ranged from 16 to 75 years and initial shockable cardiac rhythms, witnessed events, and a reversible primary cause of cardiac arrest were considered favorable prognostic factors. CPR duration and time to hospital cannulation varied considerably. Coronary revascularization, hemodynamic interventions and targeted temperature management neuroprotection were variable. A total of 833 patients receiving this ECPR approach had an overall reported survival rate of Abbreviations: ECPR, extracorporeal resuscitation; ROSC, return of spontaneous circulation; OHCA, out-of-hospital cardiac arrest; CPC, cerebral performance category; GOS, Glasgow Outcome Scale; LOE, level of evidence; ILCOR, International Liaison Committee on Resuscitation; RCTs, randomized controlled trials; TTM, targeted temperature management; IABP, intra-aortic balloon pump; DBD, donation after brain death; cDCD, controlled donation after circulatory determination of death; ELSO, extracorporeal life support organization. I. Ortega-Deballon et al. / Resuscitation 101 (2016) 12-20 13 22%, including 13% with good neurological recovery. Additionally, 88 potential and 17 actual deceased organ donors were identified among the non-survivor population in 8 out of 20 included studies. Study heterogeneity precluded a meta-analysis preventing any meaningful comparison between protocols, interventions and outcomes. Conclusions: ECPR is feasible for refractory OHCA of cardiac origin in adult patients. It may enable neurologically good survival in selected patients, who practically have no other alternative in order to save their lives with quality of life, and contribute to organ donation in those who die. Large, prospective studies are required to clarify patient selection, modifiable outcome variables, risk-benefit and cost-effectiveness.

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Section: Ecpr Studiesmentioning

confidence: 99%

Section: Ecpr Studiesmentioning

confidence: 99%

Section: Ecpr Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of Nasal Nitric Oxide Measurement as a Diagnostic Test for Primary Ciliary Dyskinesia: A Systematic Review and Meta-Analysis

Shapiro

Josephson

Rosenfeld³

et al. 2017

Annals ATS

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“…As the patient was suffering from VF with agonal breathing12 by the time the patient was admitted to our resuscitation bay, she was likely found shortly after collapse. However, VF was refractory to conventional treatment; we used ECMO as a recent study showed its clinical benefits 13, 14. By a multidisciplinary approach including ECMO, we could discharge the present patient with no neurological abnormalities.…”

Section: Discussionmentioning

confidence: 92%

Cardiac arrest caused by sibutramine obtained over the Internet: a case of a young woman without pre‐existing cardiovascular disease successfully resuscitated using extracorporeal membrane oxygenation

Bunya

Sawamoto

Uemura

et al. 2017

Acute Medicine & Surgery

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CaseSibutramine is a weight loss agent that was withdrawn from the market in the USA and European Union because it increases adverse events in patients with cardiovascular diseases. However, non‐prescription weight loss pills containing sibutramine can be still easily purchased over the Internet.A 21‐year‐old woman without history of cardiovascular diseases developed cardiac arrest. She was a user of a weight loss pills, containing sibutramine and hypokalemia‐inducing agents, imported from Thailand over the Internet.OutcomeShe was successfully resuscitated without any neurological deficits by using extracorporeal membrane oxygenation for refractory ventricular fibrillation.ConclusionThis case indicates that sibutramine can cause cardiac arrest even in subjects without pre‐existing cardiovascular disease when combined with agents that promote QT prolongation.

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“…Based on reports by the SAVE‐J study group,3 the indications for ECPR in our institution are as follows: (i) patients aged ≤65 years whose OHCA was witnessed by a bystander and in whom an initial shockable rhythm was found; or (ii) patients aged ≤70 years whose OHCA was witnessed by emergency medical service personnel and who were presumed to have a reversible underlying etiology, regardless of the initial rhythm. This case met almost all ECPR initiation criteria, and as the patient did not have pericardial effusion according to transthoracic echocardiography findings, his condition was not actively suspected to be an AAD; therefore, he was successfully resuscitated with ECPR.…”

Section: Discussionmentioning

confidence: 99%

Treatment of a patient with acute aortic dissection using extracorporeal cardiopulmonary resuscitation after an out‐of‐hospital cardiac arrest: a case report

Yukawa

Sugiyama

Miyazaki

et al. 2017

Acute Medicine & Surgery

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CaseCirculatory support using veno‐arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66‐year‐old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation. We suspected acute coronary syndrome, so coronary angiography was carried out. Enlargement of ascending aorta was noted. Whole‐body enhanced computed tomography was subsequently performed, leading to a final diagnosis of acute aortic dissection.OutcomeEmergency ascending aorta prosthesis implantation was performed. The patient received intensive care and was discharged on day 49 of hospitalization. His cerebral performance category score was 4 at discharge.ConclusionThis case suggests that veno‐arterial extracorporeal membrane oxygenation may be used for patients with aortic dissection presenting with cardiac arrest.

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Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: A prospective observational study

Cited by 462 publications

References 22 publications

Accuracy of Nasal Nitric Oxide Measurement as a Diagnostic Test for Primary Ciliary Dyskinesia: A Systematic Review and Meta-Analysis

Accuracy of Nasal Nitric Oxide Measurement as a Diagnostic Test for Primary Ciliary Dyskinesia: A Systematic Review and Meta-Analysis

Cardiac arrest caused by sibutramine obtained over the Internet: a case of a young woman without pre‐existing cardiovascular disease successfully resuscitated using extracorporeal membrane oxygenation

Treatment of a patient with acute aortic dissection using extracorporeal cardiopulmonary resuscitation after an out‐of‐hospital cardiac arrest: a case report

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