PMID- 19231388
OWN - NLM
STAT- MEDLINE
DCOM- 20090320
LR  - 20220309
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 87
IP  - 3
DP  - 2009 Mar
TI  - Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation in 
      adults.
PG  - 778-85
LID - 10.1016/j.athoracsur.2008.12.079 [doi]
AB  - BACKGROUND: Extracorporeal membrane oxygenation (ECMO) to support cardiopulmonary 
      resuscitation (CPR) has been shown to improve survival in children and adults. We 
      describe outcomes after the use of ECMO to support CPR (E-CPR) in adults using 
      multiinstitutional data from the Extracorporeal Life Support Organization (ELSO) 
      registry. METHODS: Patients greater than 18 years of age using ECMO to support 
      CPR (E-CPR) during 1992 to 2007 were extracted from the ELSO registry and 
      analyzed. RESULTS: Two hundred and ninety-seven (11% of 2,633 adult ECMO uses) 
      reports of E-CPR use in 295 patients were analyzed. Median age was 52 years 
      (interquartile range [IQR], 35, 64) and most patients had cardiac disease (n = 
      221; 75%). Survival to hospital discharge was 27%. Brain death occurred in 61 
      (28%) of nonsurvivors. In a multivariate logistic regression model, pre-ECMO 
      factors including a diagnosis of acute myocarditis (odds ratio [OR]: 0.18; 95% 
      confidence interval [CI]: 0.05 to 0.69) compared with noncardiac diagnoses and 
      use of percutaneous cannulation technique (OR: 0.42; 95% CI: 0.21 to 0.87) 
      lowered odds of mortality, whereas a lower pre-ECMO arterial blood partial 
      pressure of oxygen (Pao(2)) less than 70 mm Hg (OR: 2.7; 95% CI: 1.21 to 6.07) 
      compared with a Pao(2)of 149 mm Hg or greater increased odds of mortality. The 
      need for renal replacement therapy during ECMO increased odds of mortality (OR: 
      2.41; 95% CI: 1.34 to 4.34). CONCLUSIONS: The use of E-CPR was associated with 
      survival in 27% of adults with cardiac arrest facing imminent mortality. Further 
      studies are warranted to evaluate and better define patients who may benefit from 
      E-CPR.
FAU - Thiagarajan, Ravi R
AU  - Thiagarajan RR
AD  - Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts 
      02115, USA. ravi.thiagarajan@cardio.chboston.org
FAU - Brogan, Thomas V
AU  - Brogan TV
FAU - Scheurer, Mark A
AU  - Scheurer MA
FAU - Laussen, Peter C
AU  - Laussen PC
FAU - Rycus, Peter T
AU  - Rycus PT
FAU - Bratton, Susan L
AU  - Bratton SL
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2009 Mar;87(3):785. PMID: 19231389
CIN - Ann Thorac Surg. 2010 Jan;89(1):345-6; author reply 346. PMID: 20103290
MH  - Adult
MH  - Cardiopulmonary Resuscitation/*methods
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
EDAT- 2009/02/24 09:00
MHDA- 2009/03/21 09:00
CRDT- 2009/02/24 09:00
PHST- 2008/09/16 00:00 [received]
PHST- 2008/12/22 00:00 [revised]
PHST- 2008/12/24 00:00 [accepted]
PHST- 2009/02/24 09:00 [entrez]
PHST- 2009/02/24 09:00 [pubmed]
PHST- 2009/03/21 09:00 [medline]
AID - S0003-4975(08)02748-3 [pii]
AID - 10.1016/j.athoracsur.2008.12.079 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2009 Mar;87(3):778-85. doi: 10.1016/j.athoracsur.2008.12.079.