Abstract 16388: Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation in Patients with In-Hospital Cardiac Arrest: A Propensity Score Analysis
Introduction: Whether the survival of in-hospital cardiac arrest victims could be extended by extracorporeal cardiopulmonary resuscitation (E-CPR) supported with extracorporeal membrane oxygenation (ECMO) compared to conventional CPR (C-CPR) is still not well determined.
Methods: We retrospectively analyzed a total of 406 adult patients with witnessed in-hospital cardiac arrest receiving CPR more than 10 minutes, from January 2003 to June 2009 (85 in the E-CPR and 321 in the C-CPR).
Results: The primary endpoint was a survival discharge with minimal neurologic impairment. Propensity score matching was used to balance the baseline characteristics and CPR variables that could potentially affect prognosis. In the matched population (n = 120), the survival discharge rate with minimal neurologic impairment in E-CPR group was significantly higher than C-CPR group (23.3% versus 5% odds ratio[OR] 0.17, 95% confidence interval[CI] 0.04 to 0.63, p =0.008). In addition, there was a significant difference in the six-month survival with minimal neurologic impairment(hazard ratio[HR] 0.51, 95% CI 0.34 to 0.77, p<0.001 by log-rank test). In subgroup with cardiac origin, E-CPR also showed a benefit in survival discharge(OR 0.19, 95% CI 0.05 to 0.75, p=0.018) and 6-month survival with minimal neurologic impairment(HR 0.55, 95% CI 0.34 to 0.88, p=0.013; p=0.002 by log-rank test)
Conclusions: E-CPR showed a survival benefit over C-CPR in patients with witnessed in-hospital arrest, who received CPR of more than 10 minutes, especially with cardiac origin.
- © 2010 by American Heart Association, Inc.