Extracorporeal Life Support and New Therapeutic Strategies for Cardiac Arrest Caused by Acute Myocardial Infarction - a Critical Approach for a Critical Condition

Benedek, Theodora; M, Popovici; Glogar, Dietmar

doi:10.1515/jccm-2016-0025

Cited by 3 publications

(3 citation statements)

References 88 publications

(108 reference statements)

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“…These findings indicate that after cardiac arrest, hypoxic brain injury is a complicated and reactive process, which involves an interaction among initial hypoxic damage, reperfusion injury, subsequent oxidative reactions, and apoptotic reactions [ 39 , 40 ]. New strategies to prevent or alleviate neurologic injury after ECPR, including pharmacologic vasodilation [ 41 ], post-ECPR conditioning [ 39 , 42 ], or systemic [ 43 , 44 ] or intracranial therapeutic hypothermia [ 45 ], are potential innovative treatments to improve neurologic outcomes after ECPR.…”

Section: Discussionmentioning

confidence: 99%

Effect of interplay between age and low-flow duration on neurologic outcomes of extracorporeal cardiopulmonary resuscitation

Wang

Chi

et al. 2018

Intensive Care Med

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PurposeCaseloads of extracorporeal cardiopulmonary resuscitation (ECPR) have increased considerably, and hospital mortality rates remain high and unpredictable. The present study evaluated the effects of the interplay between age and prolonged low-flow duration (LFD) on hospital survival rates in elderly patients to identify subgroups that can benefit from ECPR.MethodsAdult patients who received ECPR in our institution (2006–2016) were classified into groups 1, 2, and 3 (18–65, 65–75, and > 75 years, respectively). Data regarding ECPR and adverse events during hospitalization were collected prospectively. The primary end point was favorable neurologic outcome (cerebral performance category 1 or 2) at hospital discharge.ResultsIn total, 482 patients were divided into groups 1, 2, and 3 (70.5%, 19.3%, and 10.2%, respectively). LFDs were comparable among the groups (40.3, 41.0, and 44.3 min in groups 1, 2, and 3, P = 0.781, 0.231, and 0.382, respectively). Favorable neurologic outcome rates were nonsignificantly lower in group 3 than in the other groups (27.6%, 24.7%, and 18.4% for group 1, 2, and 3, respectively). Subgroup analysis revealed that the favorable neurologic outcome rates in group 1 were 36.7%, 25.4%, and 13.0% for LFDs of < 30, 30–60, and > 60 min, respectively (P = 0.005); in group 2, they were 32.1%, 21.2%, and 23.1%, respectively (P = 0.548); in group 3 they were 25.0%, 20.8%, and 0.0%, respectively (P = 0.274).ConclusionOn emergency consultation for ECPR, age and low-flow duration should be considered together to predict neurologic outcome.Electronic supplementary materialThe online version of this article (10.1007/s00134-018-5496-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Effect of interplay between age and low-flow duration on neurologic outcomes of extracorporeal cardiopulmonary resuscitation

Wang

Chi

et al. 2018

Intensive Care Med

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“…However, the results were significantly worse in OHCA than in-hospital cardiac arrest (IHCA). [60][61][62][63] A recent meta-analysis on the efficacy of extracorporeal cardiopulmonary resuscitation compared to conventional CPR revealed no differences in survival rates and neurologic outcomes in OHCA patients, despite this therapy leading to improved survival and better neurologic outcome in IHCA of cardiac origin. 64 Another approach, which raises serious ethical questions, is the use of extracorporeal membrane oxygenation (ECMO) to preserve organs for transplantation from refractory OHCA patients.…”

Section: Post-resuscitation Supportive Therapy In Ohca Patientsmentioning

confidence: 99%

New Developments in the Treatment of Acute Myocardial Infarction Associated with Out-of-Hospital Cardiac Arrest. A Review

Marton-Popovici

Glogar

2016

Journal of Cardiovascular Emergencies

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Out-of-hospital cardiac arrest (OHCA) occurring as the first manifestation of an acute myocardial infarction is associated with very high mortality rates. As in comatose patients the etiology of cardiac arrest may be unclear, especially in cases without ST-segment elevation on the surface electrocardiogram, the decision to perform or not to perform urgent coronary angiography can have a significant impact on the prognosis of these patients. This review summarises the current knowledge and recommendations for treating patients with acute myocardial infarction presenting with OHCA. New therapeutic measures for the post-resuscitation phase are presented, such as hypothermia or extracardiac life support, together with strategies aiming to restore the coronary flow in the resuscitation phase using intra-arrest percutaneous revascularization performed during resuscitation. The role of regional networks in providing rapid access to the hospital facilities and to a catheterization laboratory for these critical cardiovascular emergencies is described.

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“…In recent years, novel cardiac markers have provided an effective method for the early diagnosis of AMI[ 3 ]. AMI patients receive treatment with percutaneous coronary intervention to dredge the blocked blood vessel, significantly reducing the incidence of adverse cardiac events[ 4 ]. However, many patients eventually succumb to adverse cardiac events due to severe systemic or local cardiac inflammation.…”

Section: Introductionmentioning

confidence: 99%

Early cardiopulmonary resuscitation on serum levels of myeloperoxidase, soluble ST2, and hypersensitive C-reactive protein in acute myocardial infarction patients

Hu¹,

Ren²,

Wang³

et al. 2021

WJCC

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BACKGROUND Prompt and effective cardiopulmonary resuscitation (CPR) can promote the recovery of spontaneous circulation to some extent and can save patients’ lives. The minimum target of cardiac resuscitation is the restoration of spontaneous circulation (ROSC). However, owing to prolonged sudden cardiac arrest, there is relatively high mortality within 24 h after cardiac resuscitation. Moreover, severe cerebral anoxia can deteriorate the prognosis of patients. Therefore, it is important to adopt an effective clinical evaluation of acute myocardial infarct (AMI) patients’ prognosis after cardiac resuscitation for the purpose of prevention and management. AIM To investigate early CPR effects on human myeloperoxidase (MPO), soluble ST2 (sST2), and hypersensitive C-reactive protein (hs-CRP) levels in AMI patients. METHODS In total, 54 patients with cardiac arrest caused by AMI in our hospital were selected as the observation group, and 50 other patients with AMI were selected as the control group. The differences in serum levels of MPO, sST2, and hs-CRP between the observation group and the control group were tested, and the differences in the serum levels of MPO, sST2, and hs-CRP in ROSC and non-ROSC patients, and in patients who died and in those who survived, were analyzed. RESULTS Serum levels of MPO, sST2, hs-CRP, lactic acid, creatine kinase isoenzyme (CK-MB), and cardiac troponin I (cTnI) were significantly higher in the observation group than in the control group ( P < 0.05). Serum levels of MPO, sST2, hs-CRP, lactic acid, CK-MB, and cTnI in the observation group were lower after CPR than before CPR ( P < 0.05). In the observation group, MPO, sST2, hs-CRP, lactic acid, CK-MB, and cTnI serum levels were lower in ROSC patients than in non-ROSC patients ( P < 0.05). MPO, sST2, hs-CRP, and lactic acid serum levels of patients who died in the observation group were higher than those of patients who survived ( P < 0.05). The areas under receiver operating characteristic curve predicted by MPO, sST2, hs-CRP, lactic acid, CK-MB, and cTnI were 0.616, 0.681, 0.705, 0.704, 0.702, and 0.656, respectively ( P < 0.05). The areas under receiver operating characteristic curve for MPO, SST2, hs-CRP, and lactic acid to predict death were 0.724, 0.800, 0.689, and 0.691, respectively ( P < 0.05). Logistic regression analysis showed that MPO, sST2, and hs-CRP were the influencing factors of ROSC [odds ratios = 1.667, 1.589, and 1.409, P < 0.05], while MPO, sST2, hs-CRP, and lactic acid were the influencing factors of death (odds ratios = 1.624, 1.525, 1.451, and 1.365, P < 0.05). CONCLUSION Serum levels of MPO, sST2, hs-CRP, and lactic acid have a certain value in predicting recovery an...

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Extracorporeal Life Support and New Therapeutic Strategies for Cardiac Arrest Caused by Acute Myocardial Infarction - a Critical Approach for a Critical Condition

Cited by 3 publications

References 88 publications

Effect of interplay between age and low-flow duration on neurologic outcomes of extracorporeal cardiopulmonary resuscitation

Effect of interplay between age and low-flow duration on neurologic outcomes of extracorporeal cardiopulmonary resuscitation

New Developments in the Treatment of Acute Myocardial Infarction Associated with Out-of-Hospital Cardiac Arrest. A Review

Early cardiopulmonary resuscitation on serum levels of myeloperoxidase, soluble ST2, and hypersensitive C-reactive protein in acute myocardial infarction patients

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