ECMO life-support proved more efficient than conventional CPR
Extracorporeal life-support as an adjunct to cardiac resuscitation has shown encouraging outcomes in patients with cardiac arrest. However, there is little evidence about the benefit of the procedure compared with conventional cardiopulmonary resuscitation (CPR), especially when continued for more than 10 min. Study was aimed to assess whether extracorporeal CPR was better than conventional CPR for patients with in-hospital cardiac arrest of cardiac origin.
Methods: A 3-year prospective observational study on the use of extracorporeal life-support for patients aged 18—75 years with witnessed in-hospital cardiac arrest of cardiac origin undergoing CPR of more than 10 min compared with patients receiving conventional CPR. Of the 975 patients with in-hospital cardiac arrest events who underwent CPR for longer than 10 min, 113 were enrolled in the conventional CPR group and 59 were enrolled in the extracorporeal CPR group.
The primary endpoint was survival to hospital discharge.
Results:
- Unmatched patients who underwent extracorporeal CPR had a higher survival rate to discharge and a better 1-year survival than those who received conventional CPR
- Between the propensity-score matched groups, there was still a significant difference in survival to discharge, 30-day survival and 1-year survival favouring extracorporeal CPR over conventional CPR.
- 82 percent of cardiac arrest patients who owed their survival to ECMO procedure returned to work within one year.
Conclusion: Extracorporeal CPR had a short-term and long-term survival benefit over conventional CPR in patients with in-hospital cardiac arrest of cardiac origin.
Reference: click to get abstract
Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis - The Lancet, Volume 372, Issue 9638, Pages 554 - 561, 16 August 2008
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