Discharge survival of patients undergoing ECMO therapy after ECPR in a third level hospital

Castillo García, J.; Sánchez Salado, J.C.; Gual Santandreu, M.; Molina Mazón, C.S.; Blasco Lucas, A.; Sbraga, F.; López Sánchez, G.

doi:10.1016/j.enfie.2020.03.003

ISSN: 2529-9840

Enfermería Intensiva (Intensive Care Nursing) is a peer reviewed journal that has been published for the past 27 years. It publishes original research articles on nursing interventions on the critically ill patient (Intensive Care, semi-critical, Emergency Department, as well outside the hospital), not only in adults, but also in newborns, infants and children in their different healthcare environments.
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Vol. 32. Issue 2.

Pages 73-78 (April - June 2021)

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Vol. 32. Issue 2.

Pages 73-78 (April - June 2021)

Original article

DOI: 10.1016/j.enfie.2020.03.003

Discharge survival of patients undergoing ECMO therapy after ECPR in a third level hospital

Supervivencia al alta hospitalaria de los pacientes sometidos a terapia ECMO tras PCR en un hospital de tercer nivel

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J. Castillo Garcíaa,

Corresponding author

jordicastillogarcia@gmail.com

Corresponding author.

, J.C. Sánchez Saladob, M. Gual Santandreub, C.S. Molina Mazónc, A. Blasco Lucasd, F. Sbragad, G. López Sáncheza

a Enfermería, Perfusionista, Quirófano, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

b Cardiología, Unidad Coronaria, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

c Enfermería, Unidad Coronaria, Supervisión, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

d Cirugía Cardiaca, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

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Table 1. Baseline data of the patients and their differentiation between groups.

Table 2. Clinical characteristics of patients undergoing ECMO during or after CPA, mortality, and results.

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Abstract

Goal

The goal of this study was to assess the survival to hospital discharge in patients after the implementation of venoarterial-extracorporeal membrane oxygenation (VA-ECMO) during cardiopulmonary arrest (simultaneously or during the first six hours after the event) in a Spanish tertiary hospital.

Method

This is a descriptive and retrospective study conducted with patients subjected to VA-ECMO therapy during or after cardiopulmonary resuscitation (CPR) in the last 10 years. The variables were extracted from the electronic medical record of each patient.

Results

175 ECMO therapies were implemented, 84% (147) were VA-ECMO, and the indication for 17% (25) was CPR. In 40% (10), ECMO therapy was initiated simultaneously during CPR, and the rest (15) during the first six hours after the event. Survival rates reached 44%.

Conclusions

The use of CPR in well-selected patients can improve their survival.

Keywords:

Cardiopulmonary resuscitation

Extracorporeal membrane oxygenation

Cardiac arrest

ECPR

Extracorporeal circulation

Resumen

Objetivo

El objetivo del estudio fue analizar la supervivencia al alta hospitalaria de los pacientes tras la instauración de una membrana de oxigenación extracorpórea veno-arterial (ECMO-VA) en contexto de Paro Cardiorrespiratorio (simultáneamente o durante las 6 horas posteriores a ésta) en un hospital de tercer nivel español.

Metodología

Estudio descriptivo y retrospectivo de los pacientes sometidos a una terapia ECMO-VA durante o tras maniobras de Reanimación Cardiopulmonar (RCP) en los últimos 10 años. Las variables fueron extraídas de la Historia Clínica electrónica de cada paciente.

Resultados

Se implantaron 175 ECMO, el 84% (147) fueron ECMO-VA y el 17% (25) su indicación fue durante o después de la RCP. De éstos últimos, el 40% (10) la terapia ECMO se inició simultáneamente durante las maniobras de RCP y el resto (15) en las 6 horas posteriores. Se obtuvieron tasas de supervivencia del 44%.

Conclusiones

El uso de la ECMO durante la RCP a pacientes bien seleccionados puede mejorar su supervivencia.

Palabras clave:

Reanimación cardiopulmonar

Oxigenación por membrana extracorpórea

Parada cardiorrespiratoria

ERCP

Circulación extracorpórea

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