Abstract
Background
Data on extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital
cardiac arrest (OHCA) and initially nonshockable rhythms are limited.
Objective
This study aimed to evaluate the long-term neurological outcomes of ECPR for patients
with OHCA and initially nonshockable rhythms.
Methods
In this single-center, consecutive, retrospective, observational study, patients with
OHCA and initially nonshockable rhythms who underwent ECPR between January 2012 and
December 2017 were included. All patients with refractory cardiopulmonary arrest were
transported while undergoing conventional CPR and received ECPR on arrival in the
emergency department. We retrospectively collected characteristics at admission and
neurological outcomes at the last visit or telephone interview. Cerebral performance
category (CPC) scales 1 and 2 were defined as good neurological outcomes and CPC scales
3, 4, and 5 were defined as poor neurological outcomes.
Results
Of the 39 patients included in this study, 32 died in the hospital and only 7 survived.
There were 4, 0, 0, 3, and 32 patients with CPC 1, 2, 3, 4, and 5, respectively. The
proportion of good neurological outcomes for all patients was 10.3% (95% CI 2.9–24.2%)
and 14.3% (95% CI 4.0–32.7%) for patients with pulseless electrical activity. No patients
with asystole had a good neurological outcome. Median follow-up period was 1052 days
(interquartile range 116–1589 days) for those who survived to discharge.
Conclusions
Approximately 10% of initially nonshockable patients with OHCA, generally considered
to be a poor prognosis, could acquire good neurological outcomes when they underwent
ECPR with our indications.
Keywords
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Article info
Publication history
Published online: August 12, 2022
Accepted:
August 4,
2022
Received in revised form:
July 2,
2022
Received:
October 9,
2021
Footnotes
Motonori Takahagi and Taiki Moriyama are currently at Hyogo College of Medicine, Nishinomiya City, Hyogo Prefecture, Japan
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
