Premium
Comparable Outcome of Out‐of‐Hospital Cardiac Arrest and In‐Hospital Cardiac Arrest Treated With Extracorporeal Life Support
Author(s) -
Ellouze Omar,
Vuillet Melitine,
Perrot Justine,
Grosjean Sandrine,
Missaoui Anis,
Aho Serge,
Malapert Ghislain,
Bouhemad Belaid,
Bouchot Oliver,
Girard Claude
Publication year - 2018
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12992
Subject(s) - medicine , extracorporeal cardiopulmonary resuscitation , extracorporeal , cardiopulmonary resuscitation , extracorporeal circulation , multivariate analysis , life support , extracorporeal membrane oxygenation , return of spontaneous circulation , refractory (planetary science) , retrospective cohort study , resuscitation , creatinine , cardiology , anesthesia , intensive care medicine , physics , astrobiology
Extracorporeal life support (ECLS) has shown benefits in the management of refractory in‐hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out‐of‐hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single‐center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality. Over the 4‐year period, 65 patients were included, 43 in the IHCA group (66.2%), and 22 (33.8%) in the OHCA group. The duration of low flow was significantly longer in the OHCA group (60 vs. 90 min, P = 0.004). Survival to discharge from the hospital was identical in the two groups (27% in the OHCA group vs. 23% in the IHCA group, P = 0.77). All surviving patients in the OHCA group had a cerebral performance categories score of 1–2. In multivariate analysis, we found that the initial lactate level and baseline blood creatinine were independently associated with mortality. We found comparable survival and neurological score in patients who presented IHCA and OHCA treated with ECLS. We believe that appropriate selection of patients and optimization of organ perfusion during resuscitation can lead to good results in patients with OHCA treated with ECLS.