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Outcomes of adult patients supported by extracorporeal membrane oxygenation (ECMO) following cardiopulmonary arrest. The Mayo Clinic experience
Author(s) -
Guru Pramod K,
Seelhammer Troy G,
Singh Tarun D,
Sanghavi Devang K,
Chaudhary Sanjay,
Riley Jeffrey B,
Friedrich Tammy,
Stulak John M,
Haile Dawit T,
Kashyap Rahul,
Schears Gregory J
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15804
Subject(s) - medicine , asystole , extracorporeal membrane oxygenation , cardiopulmonary resuscitation , pulseless electrical activity , extracorporeal cardiopulmonary resuscitation , retrospective cohort study , intensive care unit , life support , extracorporeal , ventricular fibrillation , anesthesia , ventricular tachycardia , membrane oxygenator , cardiology , resuscitation , intensive care medicine
To describe our experience in use of extracorporeal life support (ECLS) as a rescue strategy in patients following cardiopulmonary resuscitation. Methods A retrospective analysis was performed for patients ( n = 101) who received ECLS after cardiorespiratory arrest between May 2001 and December 2014. The primary outcome was survival to hospital discharge. Results In this cohort median (IQR) age was 56 (37‐67) years, 53 (53%) were male, and 90 (89%) were Caucasian. Ventricular tachycardia or ventricular fibrillations were the initial cardiac rhythm in 49 (48.5%) and asystole/pulseless electrical activity in 37 (36.8%). Median (IQR) time to initiation of extracorporeal support from arrest time was 72 (43–170) min. The median (IQR) duration of support was 100 (47‐157) hours. Renal failure (66%) and bleeding (66%) were the two most commonly observed complications during ECLS support. The survival to hospital discharge was seen in 47 (47%) patients, and good neurologic outcome (mRs 0–3) was seen in 29%. Acidosis, lactate and continuous renal replacement therapy were independent predictors of mortality. The median (IQR) intensive care unit stay was 14 (4–28) days and hospital stay was 17 (4–35) days. Conclusion Our institutional experience with ECLS as a rescue measure following cardiac arrest is associated with improvement in mortality, and favorable neurologic status at hospital discharge.