Abstract 19037: Current Status of Extracorporeal Cardiopulmonary Resuscitation for Cardiac Arrest Patients in Japan - The Results of Nationwide Questionaire
Introduction: The 2015 AHA guidelines have reported that in settings where it could be rapidly implemented, extracorporeal cardiopulmonary resuscitation (ECPR) may be considered for select cardiac arrest patients in whom the suspected etiology of the cardiac arrest is potentially reversible during a limited period of mechanical cardiorespiratory support (Class 2b). In Japan, ECPR has spread year by year, but the criteria and the strategy for ECPR in each emergency hospital are variable and no standardization exists.
Methods: We developed a questionnaire consisting of 54 questions about criteria, protocol, procedure technique, management, problem of ECPR and circulated the questionnaire to 126 emergency hospitals in Japan.
Results: 41(33%) of the hospitals answered the survey. These institutions peformed ECPR less than 5 cases in 21 (51%), 6-20 in 14 (34%), and more than 20 in 6 (15%) during year of 2015. The routine use of XRAY for the placement of ECPR was always or almost always in 26 institutions (63%) while sometimes or almost never 15 institutions (37%). Percutaneous vascular access was peformed in 39 institutions (95%). ECPR wsa performed by physicians in emergency department (ED) (17), intensivist (4), cardiothoracic surgeon (4) and cardiologist (30). The average time interval from hospital arrival to the implementation of ECPR for out-of-hospital cardiac arrrest patients was less than 15 minutes in 5 institutions (12%), 15-30 minutes in 22 institutions (54%) and 31-60 minutes in 14 institutions (34%). Conorary angiography after ECPR was peformed in 39 institutions (95%). The number performing insertion of sheath to distal limb to prevent distal limb ischemia is 21 (51%) before the confirmation of distal ischemia and 16 (39%) after it.
Conclusion: In Japan, we have implemented ECPR by percutaneous vascular access using XRAY with relatively short period after cardiac arrest patients arrived to the hospital and cannulation is most frequency performed by physicians in ED or cardiologist. Almost all institutions employing ECPR usage, we have held a training course for standardization of the protocal. The Japanease experience may help inform the development of ECPR programs in other countreies.
Author Disclosures: N. Ito: None. D.F. Gaieski: None. H. Hirose: None. J. Tonna: None. K. Nishiyama: None. N. Kitamura: None. T. Sakamoto: None. H. Nonogi: None. K. Nagao: None.
- © 2016 by American Heart Association, Inc.