Management of out-of hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation in 2021

Gaisendrees, Christopher; Vollmer, Matias; Walter, Sebastian; Djordjevic, Ilija; Eghbalzadeh, Kaveh; Kaya, Süreyya; Elderia, Ahmed; Ivanov, Borko; Gerfer, Stephen; Kuhn, Elmar; Sabashnikov, Anton; Kahlert, Heike Annelie; Deppe, A.-C.; Kröner, A.; Mader, Navid; Wahlers, Thorsten

doi:10.1080/17434440.2021.1886076

Cited by 11 publications

(14 citation statements)

References 79 publications

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“…From these 12 segments, seven segments belong to the shockable class, misclassified as non-shockable signals. As mentioned in [38], not advising shock for a patient with shockable signal might lead to their death, but fortunately, in this study, the rate of this kind of misclassification is only 3.87%. A quick review of…”

Section: Resultsmentioning

confidence: 52%

LDIAED: A lightweight deep learning algorithm implementable on automated external defibrillators

Nasimi

Yazdchi

2022

PLoS ONE

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Differentiating between shockable and non-shockable Electrocardiogram (ECG) signals would increase the success of resuscitation by the Automated External Defibrillators (AED). In this study, a Deep Neural Network (DNN) algorithm is used to distinguish 1.4-second segment shockable signals from non-shockable signals promptly. The proposed technique is frequency-independent and is trained with signals from diverse patients extracted from MIT-BIH, MIT-BIH Malignant Ventricular Ectopy Database (VFDB), and a database for ventricular tachyarrhythmia signals from Creighton University (CUDB) resulting, in an accuracy of 99.1%. Finally, the raspberry pi minicomputer is used to load the optimized version of the model on it. Testing the implemented model on the processor by unseen ECG signals resulted in an average latency of 0.845 seconds meeting the IEC 60601-2-4 requirements. According to the evaluated results, the proposed technique could be used by AED’s.

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Section: Resultsmentioning

confidence: 52%

LDIAED: A lightweight deep learning algorithm implementable on automated external defibrillators

Nasimi

Yazdchi

2022

PLoS ONE

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“…4 Due to the fact that ECMO cannulation in eCPR is performed during chest compressions, the underlying cause of the cardiac arrest often remains unclear, while at least 70% of cases are cardiac-related. 5…”

Section: Discussionmentioning

confidence: 99%

Functional uni‐ventricular heart due to post‐myocardial infarction ventricular septum rupture

et al. 2022

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Ventricular septum defect (VSD) is an often lethal complication caused by myocardial infarction. We report a rare case of post-myocardial infarction ventricular septum rupture in a patient after extracorporeal cardiopulmonary resuscitation (eCPR).In the bedside echocardiography after VA ECMO cannulation, we noticed the circular, hypertrophied left ventricle with the disintegrated inter-ventricular septum (maximum dehiscence 3.3 cm), accompanied by decreased left-ventricular ejection fraction and the right ventricle being compressed by the left ventricle's free septal wall.There was no pressure-relevant inter-ventricular separation resulting in left-to-rightshunting and therefore resulting in a fully functional uni-ventricular heart.

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“…There was one article with otherwise detailed inclusion and exclusion criteria which did not report the composition of the personnel involved, which therefore had to be excluded in the review. Since there are team compositions ranging from 2 to 8 members for the same procedure, there might be room for improving e ciency and lowering programme costs [26,29]. The extracted personnel statistics would have been of more interest if there were studies on cost e ciency comparing personnel costswhich is worth investigating in the future when more studies on the costs for ECPR for refractory CA have been published [71][72][73][74][75].…”

Section: Discussionmentioning

confidence: 99%

“…The extracted personnel statistics would have been of more interest if there were studies on cost e ciency comparing personnel costswhich is worth investigating in the future when more studies on the costs for ECPR for refractory CA have been published [71][72][73][74][75]. Regarding team composition, some studies found it important to mention the specialties of the physicians but omitted mentioning the specialties of the nurses, while others even included the driver of the mobile programme [20,29]. It is di cult to imagine that studies that mention only 2 physicians did not require help from nurses or other professions [26].…”

Section: Discussionmentioning

confidence: 99%

Organisational approaches to the use of extracorporeal cardiopulmonary resuscitation for refractory out of hospital cardiac arrest: a narrative review

Nikolov

Ahl²,

Wagner

et al. 2022

Preprint

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Background: The objective of this narrative review was to provide an overview of how programmes around the world are organised regarding the use of extracorporeal cardiopulmonary resuscitation for refractory out of hospital cardiac arrest. Methods: A systematic literature search was performed in PubMed, EMBASE, ClinicalTrials.gov, the EU Clinical Trials Register, and Cochrane Library. The main parameters assessed were article type, region- population-size, cost–benefit analyses, inclusion and exclusion criteria, procedure location, team composition and outcome parameters reported. Results: Sixty-three articles were eligible for inclusion. One randomised trial had been published and 4 were ongoing. Among the 58 articles that reported data on organisational topics, 47 transported the patient to the hospital for cannulation, 10 initiated extracorporeal cardiopulmonary resuscitation on-scene and one did both. The organisations cover different populations sizes that ranged between 30,788–19,303,000 inhabitants. The most common inclusion criterion was a lower age limit of 18 years (in 86% articles), followed by an upper age limit (in 83% articles), but this varied (50 and 80 years). Other criteria were witnessed collapse (67%) and initial shockable rhythm (43%), asystole (3%), pulseless electrical activity (5%), pulmonary embolism (2%), and signs of life during cardio- pulmonary resuscitation (5%). The most common exclusion criterion was a Do-Not-Resuscitate order (38%) followed by existence of major comorbidities (36%). The extracorporeal cardiopulmonary resuscitation teams varied between 2–8 members and had various professions involved. Of the 44 studies reporting outcomes, 77% reported survival to hospital discharge. Outcome as one- (in 14%), 3- (in 5%) and 6-month survival (in 7%), Cerebral-Performance-Category-score of 1–2 was reported by 50% of the studies. Conclusion: There is variation in regional size, team composition, inclusion and exclusion criteria and reported outcomes. These discrepancies make it difficult to determine how to use extracorporeal cardiopulmonary resuscitation in the most effective manner from the current publications. Despite an increasing amount of research published in the last few years, there remains a need for better coherence to inclusion/exclusion criteria and outcome reporting, the optimal team composition and location for the procedure.

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Management of out-of hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation in 2021

Cited by 11 publications

References 79 publications

LDIAED: A lightweight deep learning algorithm implementable on automated external defibrillators

LDIAED: A lightweight deep learning algorithm implementable on automated external defibrillators

Functional uni‐ventricular heart due to post‐myocardial infarction ventricular septum rupture

Organisational approaches to the use of extracorporeal cardiopulmonary resuscitation for refractory out of hospital cardiac arrest: a narrative review

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