Abstract 17563: The Minnesota Resuscitation Consortium’s Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation
Background: In 2015, the Minnesota Resuscitation Consortium implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory VF/VT. We report the outcomes of the initial 5-month period of operations.
Methods and Results: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol. Inclusion criteria included age 18-75 years, body habitus accommodating automated LUCAS CPR, and estimated transfer time from the scene to the cardiac catheterization laboratory of ≤30 minutes. Exclusion criteria included known terminal illness, DNR/DNI status, traumatic arrest, and significant bleeding. Refractory VF/VT arrest was defined as failure to achieve sustained ROSC after treatment with 3 direct current (DC) shocks and administration of 300mg of intravenous/intra-osseous amiodarone. Patients were transported to the University of Minnesota where emergent advanced perfusion strategies, including extra-corporeal membrane oxygenation (ECMO), were provided followed by coronary angiography and PCI when appropriate. Over the first 5 months of the protocol, 27 patients were transported with on-going mechanical CPR and met the inclusion criteria. The average age was 55±6, 73% were men and 85% were white patients. The mean time from 911-call to CCL arrival was 58±7 minute. ECMO was placed in 23/27 patients an average 7±1 minutes from arrival to the CCL. Twenty-two out of 27 patients had significant coronary artery disease and received PCI. Fourteen out of 27 (52%) survived to hospital discharge and 13/14 (93%) survivors were discharged with CPC 1 or 2. Bystander CPR, intermittent ROSC and lactic acid of <12mmol/L and presence of coronary artery disease were associated with favorable outcomes.
Conclusions: The MRC refractory VF/VT protocol is feasible and led to a high functionally favorable survival rate with few complications. It represents the first organized protocol of early mobilization for this patient population in the USA.
Author Disclosures: D. Yannopoulos: None. J.A. Bartos: None. C. Martin: None. G. Raveendran: None. E. Missov: None. M. Conterato: None. R. Frascone: None. A. Trembley: None. K. Sipprell: None. R. John: None. S. George: None. K. Carlson: None. M.E. Brunsvold: None. S. Garcia: None. T.P. Aufderheide: None.
- © 2016 by American Heart Association, Inc.