Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score

Pasquier, Mathieu; Hügli, Olivier; Paal, Peter; Darocha, Tomasz; Blancher, Marc; Husby, Paul; Silfvast, Tom; Carron, Pierre-Nicolas; Rousson, Valentin

doi:10.1016/j.resuscitation.2018.02.026

Cited by 147 publications

(193 citation statements)

References 38 publications

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“…Based on a retrospective analysis of 286 patients in 18 publications, Pasquier et al developed the HOPE score, which takes into account six clinico-biological variables who are age, gender, asphyxia associated, CPR duration, serum potassium level and temperature (score calculation and predicted survival use an algorithm which is available online at: www.hypothermiascore.org). The statistical analysis showed that the area under the ROC curve for the HOPE score is more useful than kalaemia for predicting survival [12]. Saczkowski et al published an another review screening 658 patients from 40 clinical cases and 44 retrospective cohorts.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…However, the lactate level was high, and the pH was below 7, which did not prevent good clinical and neurological outcomes. HOPE and ICE scores were not available when we managed our patient but if we calculated them, the HOPE score resulted in 59% survival, and the ICE score was 0 (0 point for male sex, 0 point for no associated asphyxia and 0 point for the initial serum potassium concentration less than 5 mmol/l), corresponding to a probability of survival with a good neurological outcome of 60% [12,13]. These results, similar for the two predictive scores, raise the question of their usefulness in clinical practice.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

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Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Ledoux

Leger

2020

Scand J Trauma Resusc Emerg Med

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Background: Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary support. The use of VA-ECMO for this indication has greatly improved the vital and functional prognosis of patients. Case presentation: We report a case of a 46-year-old patient who was treated for severe hypothermia with a temperature of 22.4°C along with initial cardiac arrest, whose progression was favorable after the implementation of VA-ECMO support. Two months after initial cardiac arrest, the patient was reassessed and showed signs of complete recovery with regard to his mental and physical capacities. Conclusions: The recent international publications and groups of experts recommend the use of VA ECMO as the gold standard therapy to treat severe hypothermia. Therefore, it seems suitable to update the current knowledge on the topic by analysing the latest international publications. The performance of this technique calls into question ethical and economic factors. Two distinct medical teams tried to identify and regroup prognosis factors in predictive survival scores. They raise the question of the utility of these scores in clinical practice. Indeed, according to which survival rate should we proceed to prolonged resuscitation and implement VA-ECMO? Additional studies will be needed for external approval of these survival scores, and additional reflection by experts will be required.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Ledoux

Leger

2020

Scand J Trauma Resusc Emerg Med

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“…For instance, a person who drowns in very cold water may have a good chance for meaningful recovery if ECMO cannulation occurs promptly. However, duration of CPR while traveling to the nearest ECMO center impacts the chance for neurologically intact survival (Pasquier et al 2018). A person who is closer to an ECMO center not only has a better chance of receiving ECMO but has a better chance that such treatment will be successful.…”

Section: Mayo Clinicmentioning

confidence: 99%

Can the Principles of Research Ethics Help Us Distribute Clinical Resources More Fairly?

Giunta

2020

The American Journal of Bioethics

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“…In view of these limitations, a new multivariable score to predict survival after extracorporeal life support rewarming in hypothermic patients with cardiac arrest was recently published. 2 The Hypothermia Outcome Prediction After ECLS score is a promising new tool in modern hypothermia management. Its accuracy to predict survival with extracorporeal life support rewarming after hypothermic cardiac arrest was superior to a potassium-based prediction.…”

Section: Hypothermic Cardiac Arrest Patients' Selection Criteria For mentioning

confidence: 99%

“…Its accuracy to predict survival with extracorporeal life support rewarming after hypothermic cardiac arrest was superior to a potassium-based prediction. 2 The score includes the following 6 clinical variables determined at hospital admission: age, sex, hypothermia with or without asphyxiation, CPR duration, core temperature, and serum potassium level (online calculator available at http://www.hypothermiascore.org).…”

Section: Hypothermic Cardiac Arrest Patients' Selection Criteria For mentioning

confidence: 99%

Hypothermic Cardiac Arrest Patients’ Selection Criteria for Extracorporeal Life Support Rewarming in Extreme Cases

Podsiadło

Kosiński

Darocha

et al. 2019

Annals of Emergency Medicine

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with infection may be more stoic or familiar with the examination process, and pain will be less obvious on examination. There are other studies that also suggest that findings such as cervical, uterine, and adnexal tenderness are insensitive and nonspecific, and vary when different clinicians perform the examination. 2-5 In the "Limitations" section of the study, we acknowledged that pelvic inflammatory disease can be attributed to other organisms such as Mycoplasma genitalium, herpes, and normal flora overgrowth. However, the antibiotic regimens that the Centers for Disease Control and Prevention suggests are targeted toward chlamydia, gonorrhea, and trichomonas. Visualization or palpation provided by the pelvic examination does not clarify which organism is involved or which antibiotic is needed. We agree with the concern for patients with negative test results for sexually transmitted infections and positive results for pelvic examinations, and the related risk of chronic complications because of untreated cases. In the article, we discuss a stepwise approach that begins with urine point-of-care testing for chlamydia, gonorrhea, 6 trichomonas, candida, and clue cells. For patients with negative urine testing results, we suggested the pelvic examination can be considered to aid diagnosis. Surveillance data show that rates of sexually transmitted infections and their subsequent complications are increasing every year, as is antibiotic resistance to gonorrhea. The current approach, which relies heavily on the pelvic examination, is proving unsuccessful at combating this epidemic. Empiric treatment of all patients with positive pelvic examination results, as Dr. Swartz points out, means that almost 60% of women are being treated with antibiotics that do not truly target the cause of their infection. This approach does not necessarily resolve the patient's problem and creates resistance. The use of point-of-care sexually transmitted infection results and development of additional sensitive tests for other causes of cervicitis and pelvic inflammatory disease will aid in making a correct diagnosis. New treatment guidelines are imperative, and we encourage physicians who work in high-risk areas to repeat our study for external validity and assess whether it pertains primarily to cervicitis and not pelvic inflammatory disease.

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Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score

Abstract: In this large retrospective study we found that our score was superior to dichotomous triage based on serum potassium level in assessing which hypothermic patients in cardiac arrest would benefit from extracorporeal life support. External validation of our findings is required.

Cited by 147 publications

References 38 publications

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Can the Principles of Research Ethics Help Us Distribute Clinical Resources More Fairly?

Hypothermic Cardiac Arrest Patients’ Selection Criteria for Extracorporeal Life Support Rewarming in Extreme Cases

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