Korean Circ J.  2017 Nov;47(6):939-948. 10.4070/kcj.2017.0079.

Extracorporeal Cardiopulmonary Resuscitation with Therapeutic Hypothermia for Prolonged Refractory In-hospital Cardiac Arrest

• Kim YS
• Lee YJ
• Won KB
• Kim JW
• Lee SC
• Park CR
• Jung JP
• Choi W

• KMID: 2396487
• DOI: http://doi.org/10.4070/kcj.2017.0079

Abstract

BACKGROUND AND OBJECTIVES
We identified the impact of extracorporeal cardiopulmonary resuscitation (ECPR) followed by therapeutic hypothermia on survival and neurologic outcome in patients with prolonged refractory in-hospital cardiac arrest (IHCA).
METHODS
We enrolled 16 adult patients who underwent ECPR followed by therapeutic hypothermia between July 2011 and December 2015, for IHCA. Survival at discharge and cerebral performance category (CPC) scale were evaluated.
RESULTS
All patients received bystander cardiopulmonary resuscitation (CPR); the mean CPR time was 66.5±29.9 minutes, and the minimum value was 39 minutes. Eight patients (50%) were discharged alive with favorable neurologic outcomes (CPC 1-2). The mean follow-up duration was 20.1±24.3 months, and most deaths occurred within 21 days after ECPR; thereafter, no deaths occurred within one year after the procedure.
CONCLUSION
ECPR followed by therapeutic hypothermia could be considered in prolonged refractory IHCA if bystander-initiated conventional CPR is performed.

Keyword

Extracorporeal membrane oxygenation; Cardiopulmonary resuscitation; Hypothermia, induced

MeSH Terms

Adult
Cardiopulmonary Resuscitation*
Extracorporeal Membrane Oxygenation
Follow-Up Studies
Heart Arrest*
Humans
Hypothermia, Induced*

Figure

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  Figure 1 Enrollment criteria (July 2011 to December 2015). ECMO = extracorporeal membrane oxygenation; ECPR = extracorporeal cardiopulmonary resuscitation.

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  Figure 2 Survival curve of patients who received ECPR for prolonged, refractory IHCA. ECPR = extracorporeal cardiopulmonary resuscitation; IHCA = in-hospital cardiac arrest.

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