Abstract P163: Immediate Extracorporeal Cardiopulmonary Resuscitation Can Provide Better Neurological Outcomes In Patients With Out-of-hospital Cardiac Arrest
OBJECTIVES: The purpose of this study was to evaluate the clinical effects of extracorporeal cardiopulmonary resuscitation (ECPR) for the out-of-hospital cardiac arrest (OHCA) patients having difficulty with return of spontaneous circulation (ROSC).
METHODS and RESULTS: From April 1999 to March 2009, ECPR was performed in the 105 OHCA patients having difficulty with ROSC. Spontaneous circulation recovered in 83% of the patients. Mild hypothermia (34 degrees Celsius for 24–72 hours) was performed in the 66 patients. Total survival and favorable neurological recovery rates were 30% and 12%, respectively. The average time intervals (min) from onset to ROSC and from onset to recovery of circulation (ROC) by ROSC or cardiopulmonary bypass were 92 and 50, respectively. Receiver-operating characteristic analysis showed that a period less than 41 min for ROC was the optimal period for achieving a favorable neurological recovery, with sensitivity of 77% and specificity 78% (area under the curve=0.76). The favorable neurological recovery rate of patients with witnessed VF/VT who obtained ROC within 41 min after onset (n=16) was 56%.
CONCLUSION: ECPR was considered a feasible and effective method of treating patients with OHCA if they could obtain ROC within 41 min from onset.