Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study
Abstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorpor...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-12-01
|
| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Online Access: | https://doi.org/10.1186/s13049-023-01163-0 |
| _version_ | 1797388129760444416 |
|---|---|
| author | S. A. C. Richardson D. Anderson A. J. C. Burrell T. Byrne J. Coull A. Diehl D. Gantner K. Hoffman A. Hooper S. Hopkins J. Ihle P. Joyce M. Le Guen E. Mahony S. McGloughlin Z. Nehme C. P. Nickson P. Nixon J. Orosz B. Riley J. Sheldrake D. Stub M. Thornton A. Udy V. Pellegrino S. Bernard |
| author_facet | S. A. C. Richardson D. Anderson A. J. C. Burrell T. Byrne J. Coull A. Diehl D. Gantner K. Hoffman A. Hooper S. Hopkins J. Ihle P. Joyce M. Le Guen E. Mahony S. McGloughlin Z. Nehme C. P. Nickson P. Nixon J. Orosz B. Riley J. Sheldrake D. Stub M. Thornton A. Udy V. Pellegrino S. Bernard |
| author_sort | S. A. C. Richardson |
| collection | DOAJ |
| description | Abstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia. Methods This was a single jurisdiction, single-arm feasibility study. Physicians, with pre-existing ECMO expertise, responded to witnessed OHCA, age < 65 yrs, within 30 min driving-time, using an ECMO equipped rapid response vehicle. If pre-hospital ECPR was undertaken, patients were transported to hospital for investigations and therapies including emergent coronary catheterisation, and standard intensive care (ICU) therapy until either cardiac and neurological recovery or palliation occurred. Analyses were descriptive. Results From February 2020 to May 2023, over 117 days, the team responded to 709 “potential cardiac arrest” emergency calls. 358 were confirmed OHCA. Time from emergency call to scene arrival was 27 min (15–37 min). 10 patients fulfilled the pre-defined inclusion criteria and all were successfully cannulated on scene. Time from emergency call to ECMO initiation was 50 min (35–62 min). Time from decision to ECMO support was 16 min (11–26 min). CPR duration was 46 min (32–62 min). All 10 patients were transferred to hospital for investigations and therapy. 4 patients (40%) survived to hospital discharge neurologically intact (CPC 1/2). Conclusion Pre-hospital ECPR was feasible, using an experienced ECMO team from a single-centre. Overall survival was promising in this highly selected group. Further prospective studies are now warranted. |
| first_indexed | 2024-03-08T22:35:18Z |
| format | Article |
| id | doaj.art-5fc9cb5004ae4382ac2743ea7fffb0b3 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-03-08T22:35:18Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-5fc9cb5004ae4382ac2743ea7fffb0b32023-12-17T12:28:24ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-12-013111810.1186/s13049-023-01163-0Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) studyS. A. C. Richardson0D. Anderson1A. J. C. Burrell2T. Byrne3J. Coull4A. Diehl5D. Gantner6K. Hoffman7A. Hooper8S. Hopkins9J. Ihle10P. Joyce11M. Le Guen12E. Mahony13S. McGloughlin14Z. Nehme15C. P. Nickson16P. Nixon17J. Orosz18B. Riley19J. Sheldrake20D. Stub21M. Thornton22A. Udy23V. Pellegrino24S. Bernard25The Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalAmbulance VictoriaThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalAmbulance VictoriaThe Alfred HospitalAmbulance VictoriaThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalAmbulance VictoriaThe Alfred HospitalThe Alfred HospitalThe Alfred HospitalAbstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia. Methods This was a single jurisdiction, single-arm feasibility study. Physicians, with pre-existing ECMO expertise, responded to witnessed OHCA, age < 65 yrs, within 30 min driving-time, using an ECMO equipped rapid response vehicle. If pre-hospital ECPR was undertaken, patients were transported to hospital for investigations and therapies including emergent coronary catheterisation, and standard intensive care (ICU) therapy until either cardiac and neurological recovery or palliation occurred. Analyses were descriptive. Results From February 2020 to May 2023, over 117 days, the team responded to 709 “potential cardiac arrest” emergency calls. 358 were confirmed OHCA. Time from emergency call to scene arrival was 27 min (15–37 min). 10 patients fulfilled the pre-defined inclusion criteria and all were successfully cannulated on scene. Time from emergency call to ECMO initiation was 50 min (35–62 min). Time from decision to ECMO support was 16 min (11–26 min). CPR duration was 46 min (32–62 min). All 10 patients were transferred to hospital for investigations and therapy. 4 patients (40%) survived to hospital discharge neurologically intact (CPC 1/2). Conclusion Pre-hospital ECPR was feasible, using an experienced ECMO team from a single-centre. Overall survival was promising in this highly selected group. Further prospective studies are now warranted.https://doi.org/10.1186/s13049-023-01163-0 |
| spellingShingle | S. A. C. Richardson D. Anderson A. J. C. Burrell T. Byrne J. Coull A. Diehl D. Gantner K. Hoffman A. Hooper S. Hopkins J. Ihle P. Joyce M. Le Guen E. Mahony S. McGloughlin Z. Nehme C. P. Nickson P. Nixon J. Orosz B. Riley J. Sheldrake D. Stub M. Thornton A. Udy V. Pellegrino S. Bernard Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| title | Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study |
| title_full | Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study |
| title_fullStr | Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study |
| title_full_unstemmed | Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study |
| title_short | Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study |
| title_sort | pre hospital ecpr in an australian metropolitan setting a single arm feasibility assessment the cpr pre hospital ecpr and early reperfusion cheer3 study |
| url | https://doi.org/10.1186/s13049-023-01163-0 |
| work_keys_str_mv | AT sacrichardson prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT danderson prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT ajcburrell prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT tbyrne prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT jcoull prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT adiehl prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT dgantner prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT khoffman prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT ahooper prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT shopkins prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT jihle prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT pjoyce prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT mleguen prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT emahony prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT smcgloughlin prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT znehme prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT cpnickson prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT pnixon prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT jorosz prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT briley prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT jsheldrake prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT dstub prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT mthornton prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT audy prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT vpellegrino prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study AT sbernard prehospitalecprinanaustralianmetropolitansettingasinglearmfeasibilityassessmentthecprprehospitalecprandearlyreperfusioncheer3study |