Open AccessVariability of extracorporeal cardiopulmonary resuscitation practice in patients with out‐of‐hospital cardiac arrest from the emergency department to intensive care unit in Japan
Author(s) -
Hifumi Toru,
Inoue Akihiko,
Takiguchi Toru,
Watanabe Kazuhiro,
Ogura Takayuki,
Okazaki Tomoya,
Ijuin Shinichi,
Zushi Ryosuke,
Arimoto Hideki,
Takada Hiroaki,
Shiraishi Shinichirou,
Egawa Yuko,
Kanda Jun,
Nasu Michitaka,
Kobayashi Makoto,
Sakuraya Masaaki,
Naito Hiromichi,
Nakao Shunichiro,
Otani Norio,
Takeuchi Ichiro,
Bunya Naofumi,
Shimizu Takafumi,
Sawano Hirotaka,
Takayama Wataru,
Kushimoto Shigeki,
Shoko Tomohisa,
Aoki Makoto,
Otani Takayuki,
Matsuoka Yoshinori,
Homma Koichiro,
Maekawa Kunihiko,
Tahara Yoshio,
Fukuda Reo,
Kikuchi Migaku,
Nakagami Takuo,
Hagiwara Yoshihiro,
Kitamura Nobuya,
Sugiyama Kazuhiro,
Sakamoto Tetsuya,
Kuroda Yasuhiro
Publication year - 2021
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.647
Subject(s) - extracorporeal cardiopulmonary resuscitation , medicine , extracorporeal membrane oxygenation , cardiopulmonary resuscitation , emergency department , inclusion and exclusion criteria , intensive care unit , resuscitation , intensive care , emergency medicine , extracorporeal , demographics , intensive care medicine , nursing , alternative medicine , demography , pathology , sociology
Aim A lack of known guidelines for the provision of extracorporeal cardiopulmonary resuscitation (ECPR) to patients with out‐of‐hospital cardiac arrest (OHCA) has led to variability in practice between hospitals even in the same country. Because variability in ECPR practice has not been completely examined, we aimed to describe the variability in ECPR practice in patients with OHCA from the emergency department (ED) to the intensive care units (ICU). Methods An anonymous online questionnaire to examine variability in ECPR practice was completed in January 2020 by 36 medical institutions who participated in the SAVE‐J II study. Institutional demographics, inclusion and exclusion criteria, initial resuscitation management, extracorporeal membrane oxygenation (ECMO) initiation, initial ECMO management, intra‐aortic balloon pumping/endotracheal intubation/management during coronary angiography, and computed tomography criteria were recorded. Results We received responses from all 36 institutions. Four institutions (11.1%) had a hybrid emergency room. Cardiovascular surgery was always involved throughout the entire ECMO process in only 14.7% of institutions; 60% of institutions had formal inclusion criteria and 50% had formal exclusion criteria. In two‐thirds of institutions, emergency physicians carried out cannulation. Catheterization room was the leading location of cannulation (48.6%) followed by ED (31.4%). The presence of formal exclusion criteria significantly increased with increasing ECPR volume ( P for trend <0.001). Intra‐aortic balloon pumping was routinely initiated in only 25% of institutions. Computed tomography was routinely carried out before coronary angiography in 25% of institutions. Conclusions We described the variability in ECPR practice in patients with OHCA from the ED to the ICU.