Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial?
Background: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal me...
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic and Cardiovascular Surgery
2015-10-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2015.48.5.318 |
| _version_ | 1818547238517866496 |
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| author | Seung-Hun Lee Jae-Seung Jung Kwang-Hyung Lee Hee-Jung Kim Ho-Sung Son Kyung Sun |
| author_facet | Seung-Hun Lee Jae-Seung Jung Kwang-Hyung Lee Hee-Jung Kim Ho-Sung Son Kyung Sun |
| author_sort | Seung-Hun Lee |
| collection | DOAJ |
| description | Background: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness
of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently,
many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used
during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation
(ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with
that of conventional CPR (CCPR). Methods: Between March 2009 and April 2014, CPR, including both in-hospital
and out-of-hospital CPR, was carried out in 955 patients. The ECPR group, counted from the start of the ECPR
program in March 2010, included 81 patients in total, and the CCPR group consisted of 874 patients. All data
were retrospectively collected from the patients’ medical records. Results: The return of spontaneous circulation
(ROSC) rate was 2.24 times better in CPR of in-hospital cardiac arrest (IHCA) patients than in CPR of out-of-hospital
CA (OHCA) patients (p=0.0012). For every 1-minute increase in the CPR duration, the ROSC rate decreased
by 1% (p=0.0228). Further, for every 10-year decrease in the age, the rate of survival discharge increased by
31%. The CPR of IHCA patients showed a 2.49 times higher survival discharge rate than the CPR of OHCA patients
(p=0.03). For every 1-minute increase in the CPR duration, the rate of survival discharge was decreased by
4%. ECPR showed superiority in terms of the survival discharge in the univariate analysis, although with no statistical
significance in the multivariate analysis. Conclusion: The survival discharge rate of the ECPR group was
comparable to that of the CCPR group. As the CPR duration increased, the survival discharge and the ROSC rate
decreased. Therefore, a continuous effort to reduce the time for the decision of ECMO initiation and ECMO team
activation is necessary, particularly during the CPR of relatively young patients and IHCA patients. |
| first_indexed | 2024-12-12T08:04:06Z |
| format | Article |
| id | doaj.art-c45f70f6d7e941b993589ffa789b25fc |
| institution | Directory Open Access Journal |
| issn | 2233-601X 2093-6516 |
| language | English |
| last_indexed | 2024-12-12T08:04:06Z |
| publishDate | 2015-10-01 |
| publisher | Korean Society for Thoracic and Cardiovascular Surgery |
| record_format | Article |
| series | Korean Journal of Thoracic and Cardiovascular Surgery |
| spelling | doaj.art-c45f70f6d7e941b993589ffa789b25fc2022-12-22T00:32:02ZengKorean Society for Thoracic and Cardiovascular SurgeryKorean Journal of Thoracic and Cardiovascular Surgery2233-601X2093-65162015-10-0148531832710.5090/kjtcs.2015.48.5.318Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial?Seung-Hun Lee0Jae-Seung Jung1Kwang-Hyung Lee2Hee-Jung Kim3Ho-Sung Son4Kyung Sun5Korea University Anam HospitalKorea University Anam HospitalKorea University Anam HospitalKorea University Anam HospitalKorea University Anam HospitalKorea University Anam HospitalBackground: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with that of conventional CPR (CCPR). Methods: Between March 2009 and April 2014, CPR, including both in-hospital and out-of-hospital CPR, was carried out in 955 patients. The ECPR group, counted from the start of the ECPR program in March 2010, included 81 patients in total, and the CCPR group consisted of 874 patients. All data were retrospectively collected from the patients’ medical records. Results: The return of spontaneous circulation (ROSC) rate was 2.24 times better in CPR of in-hospital cardiac arrest (IHCA) patients than in CPR of out-of-hospital CA (OHCA) patients (p=0.0012). For every 1-minute increase in the CPR duration, the ROSC rate decreased by 1% (p=0.0228). Further, for every 10-year decrease in the age, the rate of survival discharge increased by 31%. The CPR of IHCA patients showed a 2.49 times higher survival discharge rate than the CPR of OHCA patients (p=0.03). For every 1-minute increase in the CPR duration, the rate of survival discharge was decreased by 4%. ECPR showed superiority in terms of the survival discharge in the univariate analysis, although with no statistical significance in the multivariate analysis. Conclusion: The survival discharge rate of the ECPR group was comparable to that of the CCPR group. As the CPR duration increased, the survival discharge and the ROSC rate decreased. Therefore, a continuous effort to reduce the time for the decision of ECMO initiation and ECMO team activation is necessary, particularly during the CPR of relatively young patients and IHCA patients.http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2015.48.5.318Cardiac arrestOutcomesExtracorporeal membrane oxygenation |
| spellingShingle | Seung-Hun Lee Jae-Seung Jung Kwang-Hyung Lee Hee-Jung Kim Ho-Sung Son Kyung Sun Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? Korean Journal of Thoracic and Cardiovascular Surgery Cardiac arrest Outcomes Extracorporeal membrane oxygenation |
| title | Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? |
| title_full | Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? |
| title_fullStr | Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? |
| title_full_unstemmed | Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? |
| title_short | Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? |
| title_sort | comparison of extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation is extracorporeal cardiopulmonary resuscitation beneficial |
| topic | Cardiac arrest Outcomes Extracorporeal membrane oxygenation |
| url | http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2015.48.5.318 |
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