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Venoarterial extracorporeal membrane oxygenation for cardiopulmonary resuscitation: A retrospective study comparing the outcomes of fluoroscopy.
Tanaka, Soichi; Tachibana, Shunsuke; Toyohara, Takashi; Sonoda, Hajime; Yamakage, Michiaki.
Afiliación
  • Tanaka S; Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan.
  • Tachibana S; Department of Anesthesiology, Kushiro City General Hospital, Japan.
  • Toyohara T; Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan.
  • Sonoda H; Department of Emergency Medicine, Kushiro City General Hospital, Japan.
  • Yamakage M; Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan.
Heliyon ; 10(2): e24565, 2024 Jan 30.
Article en En | MEDLINE | ID: mdl-38304838
ABSTRACT

Background:

Extracorporeal cardiopulmonary resuscitation (ECPR) using venoarterial extracorporeal membrane oxygenation is performed for out-of-hospital cardiac arrest; however, it is associated with a risk of several complications.

Objective:

To investigate whether the fluoroscopy equipment was removed from the emergency department (ED) and whether it would be beneficial to transport the patient to the fluoroscopy room to reduce vascular complications without affecting the induction time.

Methods:

This single-center, retrospective, before-and-after analysis was conducted at a tertiary emergency medical center and included 59 patients who underwent ECPR for out-of-hospital cardiac arrest between May 2017 and March 2022. The patients were divided into two groups those who underwent cannulation in the ED without fluoroscopy (ED-ECPR group) and those who were transferred directly from the ED to the cardiac angiography room (ECPR call group).

Results:

The rate of vascular complications associated with ECPR was significantly lower in the ECPR group than in the ED-ECPR group (40.6 % [14/32] vs. 10 % [2/20], respectively; p = 0.014). The duration from ED arrival to venoarterial extracorporeal membrane oxygenation initiation was similar in the two groups (median 23.0 min in the ED-ECPR group vs. 25.5 min in the ECPR call group, p = 0.71). Results adjusted for confounding factors showed that performing ECPR under fluoroscopy was a consistent and independent element of vascular complication rates (adjusted odds ratio 9.92, 95 % confidence interval 2.04 to 81.2, p = 0.011).

Conclusions:

Fluoroscopy-guided ECPR can significantly reduce the incidence of vascular complications even if the ED and fluoroscopy room are far apart. However, no significant difference was observed in the time required to establish ECPR in the cardiac catheterization laboratories.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Risk_factors_studies Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Risk_factors_studies Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido