Abstract 238: Emergency Extracorporeal Life Support Versus Conventional Cardiopulmonary Resuscitation for Refractory Cardiac Arrest: An Emergency Department Registry Analysis
Background: Outcome after cardiac arrest is poor. In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 minutes, chances of survival decrease even further. Emergency extracorporeal life support (E-ECLS) has become an option for a highly selected population of cardiac arrest patients. Aim of this study was to evaluate the potential effects on outcome of E-ECLS in refractory cardiac arrest compared to ongoing standard CPR at an emergency department of a tertiary care center.
Methods: Anonymized data, of adult patients suffering cardiac arrest, treated between 2002 and 2012 and transported to our department in refractory cardiac arrest (more than 30 minutes) with ongoing hemodynamic instability and CPR were analyzed.
Results: Overall 269 patients fulfilled the inclusion criteria. Baseline parameters and outcomes are displayed in Table 1. E-ECLS was initiated in 12 patients. They were younger, but otherwise did not differ significantly in cardiac arrest specific criteria. Overall survival to discharge in good neurologic condition (defined as cerebral performance category 1 or 2) was achieved in 18 (7%) patients and was significantly higher in the group of patients receiving E-ECLS (25% vs. 6% of patients p=0.038). Correcting for age in regression analysis we still found E-ECLS to be significantly associated with survival (OR 0.65 95%CI 0.04-0.94) p=0.041).
Conclusions: Emergency extracorporeal life support for patients in refractory cardiac arrest, deployed at an emergency department with critical care capability seems to be superior to standard CPR in terms of neurologic intact survival. Randomised controlled trials are urgently needed to verify these findings.
Author Disclosures: A. Schober: None. F. Sterz: None. M. Holzer: None. C. Wallmueller: None. P. Stratil: None. A. Landerl: None. C. Weiser: None. R. Van Tulder: None. A. Laggner: None. C. Testori: None.
- © 2014 by American Heart Association, Inc.