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Favourable survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: An Italian tertiary care centre experience

2011; Elsevier BV; Volume: 83; Issue: 5 Linguagem: Inglês

10.1016/j.resuscitation.2011.10.013

1873-1570

Leonello Avalli, Elena Maggioni, Francesco Formica, G Redaelli, Maurizio Migliari, Monica Scanziani, Simona Celotti, Anna Coppo, Rosa Caruso, Giuseppe Ristagno, Roberto Fumagalli,

Cardiac Structural Anomalies and Repair

Extracorporeal membrane oxygenation (ECMO) support has been suggested to improve the survival rate in patients with refractory in- and out-of-hospital cardiac arrest (IHCA and OHCA). The aim of our study is to report our experience with ECMO in these patients.Retrospective, single-centre, observational study.From January 2006 to February 2011 we studied 42 patients (31 males) with refractory cardiac arrest.ECMO implantation was successful in 38 (90%) of the 42 patients. ECMO support was positioned: three times (8%) in the operating room, six (16%) in the cardiac surgery intensive care unit, 21 (55%) in the emergency room, five (13%) in the catheterisation laboratory and three (8%) in the general ward. A total of 14 IHCA (58%) and three OHCA (16%) patients were weaned from ECMO (p<0.05). Eleven IHCA (46%) and one OHCA (5%, p<0.05) patients were discharged from intensive care unit (ICU). Among IHCA patients, 10 were alive at 6 months, nine of whom (38%) with good neurological outcome. Among OHCA patients weaned from ECMO, one was alive at 6 months with good neurological outcome (5%, p<0.05 vs. IHCA).ECMO support should be considered as a resuscitation alternative in selected patients. More specifically, patients with witnessed IHCA benefit more from ECMO treatment compared to those who experience an out-of-hospital cardiac arrest.