PMID- 34314778
OWN - NLM
STAT- MEDLINE
DCOM- 20211101
LR  - 20220531
IS  - 1873-1570 (Electronic)
IS  - 0300-9572 (Linking)
VI  - 167
DP  - 2021 Oct
TI  - Combined use of venoarterial extracorporeal membrane oxygenation and intra-aortic 
      balloon pump after cardiac arrest.
PG  - 345-354
LID - S0300-9572(21)00271-9 [pii]
LID - 10.1016/j.resuscitation.2021.07.019 [doi]
AB  - OBJECTIVES: We investigated whether intra-aortic balloon pump (IABP) combined 
      with venoarterial extracorporeal membrane oxygenation (VA-ECMO) was associated 
      with favourable neurological outcomes for patients after the return of 
      spontaneous circulation (ROSC). Moreover, we evaluated the aetiology of cardiac 
      arrest on the effectiveness of this therapy in a sub-study. BACKGROUND: There is 
      insufficient research on the optimal combination of machines for patients after 
      ROSC is not established. METHODS: This is a large-scale, multicentre, 30-day 
      cohort study. Among 80,716 patients who delivered to the emergency room, 935 
      patients treated with VA-ECMO after ROSC were included using the data from the 
      Tokyo Cardiovascular Care Unit Network Registry between 2010 and 2017. The study 
      patients were stratified according to the use of IABP [the ECMO + IABP group 
      (n = 762) vs. the ECMO-alone group (n = 173)]. We also evaluated the cause of 
      cardiac arrest [acute coronary syndrome (ACS) and non-ACS] in the sub-study. To 
      adjust the patients' backgrounds, we used the propensity score matching for 
      additional analyses. The endpoint was 30-day favourable neurological outcome. 
      RESULTS: The ECMO + IABP group showed significantly better neurological outcomes 
      than the ECMO-alone group (crude; 35% vs. 25%; log-lank P < 0.001). In the ACS 
      subgroup, the ECMO + IABP group showed significantly better neurological outcome 
      (crude; 34% vs. 18%; log-lank P < 0.001), but not in the non-ACS subgroup (crude; 
      38% vs. 32%; log-lank P = 0.11). These results are similar after adjustments to 
      their backgrounds using propensity matching. CONCLUSIONS: Compared to VA-ECMO 
      alone, the combined use of VA-ECMO and IABP is associated with better 
      neurological outcomes after ROSC, especially in complicated ACS.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Kuroki, Norihiro
AU  - Kuroki N
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan; Department of Cardiology, 
      Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. Electronic address: 
      norihiro-kuroki@nifty.ne.jp.
FAU - Nagao, Ken
AU  - Nagao K
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Otsuka, Toshiaki
AU  - Otsuka T
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan; Department of Hygiene and 
      Public Health, Nippon Medical School, Tokyo, Japan.
FAU - Kuwabara, Masanari
AU  - Kuwabara M
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Nakata, Jun
AU  - Nakata J
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Takayama, Tadateru
AU  - Takayama T
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Hosokawa, Yusuke
AU  - Hosokawa Y
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Ashida, Tadashi
AU  - Ashida T
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Suzuki, Kou
AU  - Suzuki K
AD  - Department of Cardiology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
FAU - Yamamoto, Takeshi
AU  - Yamamoto T
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
FAU - Takayama, Morimasa
AU  - Takayama M
AD  - Tokyo CCU Network, Scientific Committee, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210724
PL  - Ireland
TA  - Resuscitation
JT  - Resuscitation
JID - 0332173
SB  - IM
CIN - Resuscitation. 2021 Oct;167:390-392. PMID: 34437993
MH  - Cohort Studies
MH  - *Extracorporeal Membrane Oxygenation
MH  - *Heart Arrest/therapy
MH  - Humans
MH  - Intra-Aortic Balloon Pumping
MH  - Shock, Cardiogenic
OTO - NOTNLM
OT  - ACS
OT  - Cardiac arrest
OT  - Cardiogenic shock
OT  - ECMO
OT  - IABP
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper. Data collection and maintenance for 
      the Tokyo Cardiovascular Care Unit Network Registry is financially supported by 
      the Tokyo Metropolitan Government, which had no role in the execution of this 
      study or the interpretation of the results.
EDAT- 2021/07/28 06:00
MHDA- 2021/11/03 06:00
CRDT- 2021/07/27 20:15
PHST- 2021/01/11 00:00 [received]
PHST- 2021/07/02 00:00 [revised]
PHST- 2021/07/15 00:00 [accepted]
PHST- 2021/07/28 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/07/27 20:15 [entrez]
AID - S0300-9572(21)00271-9 [pii]
AID - 10.1016/j.resuscitation.2021.07.019 [doi]
PST - ppublish
SO  - Resuscitation. 2021 Oct;167:345-354. doi: 10.1016/j.resuscitation.2021.07.019. 
      Epub 2021 Jul 24.