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Kim SK, Park JO, Park HA, Lee CA, Kim S, Wang SJ, Park HJ, Lee HA. Analyzing willingness for extracorporeal cardiopulmonary resuscitation in refractory ventricular fibrillation. PLoS One 2023; 18:e0281092. [PMID: 36701404 PMCID: PMC9879451 DOI: 10.1371/journal.pone.0281092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory ventricular fibrillation/ventricular tachycardia in out-of-hospital cardiac arrest has recently been recommended for selected patients with favorable prognostic features. We aimed to identify factors affecting the willingness of emergency physicians to implement extracorporeal cardiopulmonary resuscitation (ECPR). We conducted a factorial survey with nine experimental vignettes by combining three different scene time intervals and transportation time intervals. Emergency physicians reported willingness to implement ECPR (1-100 points). Respondent characteristics that could affect the willingness were studied. Multilevel analysis of vignettes and respondent factors was conducted using a mixed-effects regression model. We obtained 486 vignette responses from 54 emergency physicians. In the case of longer scene time intervals, there was a significant difference in the willingness scores at 9 and 12 min transportation time intervals. When the pre-hospital time interval was > 40 min, emergency physicians demonstrated lower willingness to implement ECPR. Clinical experience of 15-19 years showed a significant favorable effect on willingness to implement extracorporeal membrane oxygenation (ECMO). However, the mean willingness scores of EPs for ECMO implementation were more than 75 across all vignettes. In ECPR, the prehospital time interval is an important factor, and the willingness of emergency physicians to implement ECMO could be mutually affected by scene time intervals, transportation time intervals, and total prehospital time.
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Affiliation(s)
- Seon Koo Kim
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Ju Ok Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
- * E-mail:
| | - Hang A. Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Choung Ah Lee
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Sola Kim
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Soon-Joo Wang
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Hye Ji Park
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
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Risk factors for mortality in paediatric cardiac ICU patients managed with extracorporeal membrane oxygenation. Cardiol Young 2019; 29:40-47. [PMID: 30378526 DOI: 10.1017/s1047951118001774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Veno-arterial extracorporeal membrane oxygenation is frequently used in patients with cardiac disease. We evaluated short-term outcomes and identified factors associated with hospital mortality in cardiac patients supported with veno-arterial extracorporeal membrane oxygenation. METHODS A retrospective review of patients supported with veno-arterial extracorporeal membrane oxygenation at a university-affiliated children's hospital was performed. RESULTS A total of 253 patients with cardiac disease managed with extracorporeal membrane oxygenation were identified; survival to discharge was 48%, which significantly improved from 39% in an earlier era (1995-2001) (p=0.01). Patients were categorised into surgical versus non-surgical groups on the basis of whether they had undergone cardiac surgery before or not, respectively. The most common indication for extracorporeal membrane oxygenation was extracorporeal cardiopulmonary resuscitation: 96 (51%) in the surgical group and 45 (68%) in the non-surgical group. In a multiple covariate analysis, single-ventricle physiology (p=0.01), duration of extracorporeal membrane oxygenation (p<0.01), and length of hospital stay (p=0.03) were associated with hospital mortality. Weekend or night shift cannulation was associated with mortality in non-surgical patients (p=0.05). CONCLUSION We report improvement in survival compared with an earlier era in cardiac patients supported with extracorporeal membrane oxygenation. Single-ventricle physiology continues to negatively impact survival, along with evidence of organ dysfunction during extracorporeal membrane oxygenation, duration of extracorporeal membrane oxygenation, and length of stay.
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Cesana F, Avalli L, Garatti L, Coppo A, Righetti S, Calchera I, Scanziani E, Cozzolino P, Malafronte C, Mauro A, Soffici F, Sulmina E, Bozzon V, Maggioni E, Foti G, Achilli F. Effects of extracorporeal cardiopulmonary resuscitation on neurological and cardiac outcome after ischaemic refractory cardiac arrest. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 7:432-441. [PMID: 29064271 DOI: 10.1177/2048872617737041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation. METHODS We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011-2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months). RESULTS Patients in the extracorporeal cardiopulmonary resuscitation group ( n=63, 43%) were younger (59±9 vs 63±8 year-old, p=0.02) with lower incidence of atherosclerosis risk factors than those with conventional cardiopulmonary resuscitation. In the extracorporeal cardiopulmonary resuscitation group, left ventricular ejection fraction was lower than conventional cardiopulmonary resuscitation at early echocardiography (19±16% vs 37±11 p<0.01). Survivors in both groups showed similar left ventricular ejection fraction 15 days and 4-6 months after cardiac arrest (46±8% vs 49±10, 47±11% vs 45±13%, p not significant for both), despite a major extent and duration of cardiac ischaemia in extracorporeal cardiopulmonary resuscitation patients. At multivariate analysis, the total cardiac arrest time was the only independent predictor of survival. CONCLUSIONS Extracorporeal cardiopulmonary resuscitation patients are younger and have less comorbidities than conventional cardiopulmonary resuscitation, but they have worse survival and lower early left ventricular ejection fraction. Survivors after extracorporeal cardiopulmonary resuscitation have a neurological outcome and recovery of heart function comparable to subjects with return of spontaneous circulation. Total cardiac arrest time is the only predictor of survival after cardiopulmonary resuscitation in both groups.
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Affiliation(s)
| | - Leonello Avalli
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | - Laura Garatti
- 1 Cardiovascular Department, San Gerardo Hospital, Italy
| | - Anna Coppo
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | | | - Ivan Calchera
- 1 Cardiovascular Department, San Gerardo Hospital, Italy
| | | | - Paolo Cozzolino
- 3 Research Centre on Public Health, University of Milano-Bicocca, Italy
| | | | - Andrea Mauro
- 1 Cardiovascular Department, San Gerardo Hospital, Italy
| | | | - Endrit Sulmina
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | - Veronica Bozzon
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | - Elena Maggioni
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | - Giuseppe Foti
- 2 Cardiac Surgery Intensive Care, San Gerardo Hospital, Italy
| | - Felice Achilli
- 1 Cardiovascular Department, San Gerardo Hospital, Italy
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Ellouze O, Vuillet M, Perrot J, Grosjean S, Missaoui A, Aho S, Malapert G, Bouhemad B, Bouchot O, Girard C. Comparable Outcome of Out-of-Hospital Cardiac Arrest and In-Hospital Cardiac Arrest Treated With Extracorporeal Life Support. Artif Organs 2017; 42:15-21. [PMID: 28877346 DOI: 10.1111/aor.12992] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/22/2017] [Accepted: 06/14/2017] [Indexed: 12/28/2022]
Abstract
Extracorporeal life support (ECLS) has shown benefits in the management of refractory in-hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out-of-hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single-center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality. Over the 4-year period, 65 patients were included, 43 in the IHCA group (66.2%), and 22 (33.8%) in the OHCA group. The duration of low flow was significantly longer in the OHCA group (60 vs. 90 min, P = 0.004). Survival to discharge from the hospital was identical in the two groups (27% in the OHCA group vs. 23% in the IHCA group, P = 0.77). All surviving patients in the OHCA group had a cerebral performance categories score of 1-2. In multivariate analysis, we found that the initial lactate level and baseline blood creatinine were independently associated with mortality. We found comparable survival and neurological score in patients who presented IHCA and OHCA treated with ECLS. We believe that appropriate selection of patients and optimization of organ perfusion during resuscitation can lead to good results in patients with OHCA treated with ECLS.
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Affiliation(s)
- Omar Ellouze
- Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France
| | | | - Justine Perrot
- Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France
| | | | - Anis Missaoui
- Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France
| | - Serge Aho
- Service d'Epidémiologie et d'Hygiène Hospitalières, CHU de Dijon, Dijon, France
| | - Ghislain Malapert
- Service de Chirurgie Cardiaque, Vasculaire et Thoracique, CHU de Dijon, Dijon, France
| | - Belaid Bouhemad
- Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France
| | - Oliver Bouchot
- Service de Chirurgie Cardiaque, Vasculaire et Thoracique, CHU de Dijon, Dijon, France
| | - Claude Girard
- Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France
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Casadio MC, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G. Organ donation in cardiac arrest patients treated with extracorporeal CPR: A single centre observational study. Resuscitation 2017; 118:133-139. [PMID: 28596083 DOI: 10.1016/j.resuscitation.2017.06.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 05/22/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
AIM OF THE STUDY In a consecutive cohort of cardiac arrest (CA) treated with extracorporeal cardiopulmonary resuscitation (eCPR), we describe the incidence of brain death (BD), the eligibility for organ donation and the short-term follow-up of the transplanted organs. METHODS All refractory in- and out-of-hospital CA admitted to our Cardiac Intensive Care Unit between January 2011 and September 2016 treated with eCPR were enrolled in the study. RESULTS 112 CA patients received eCPR. 82 (73.2%) died in hospital, 25 BD (22.3%) and 57 for other causes (50.9%). At the time of first neurological evaluation after rewarming, variables related to evolution to BD were a lower GCS (3 [3-3] vs. 8 [3-11], p<0.001), a higher level of neuron specific enolase (269.3±49.4 vs. 55.2±37.2ng/ml, p<0.001), a higher presence of EEG indices of poor outcome (84% vs. 15%, p<0.001), absence of brainstem reflexes (p<0.001), absence of bilateral N20 SSEPS waves (66.7% vs. 3.7%, p<0.001). None of BD patients present a normal CT scan (at 2.5±2days), with 85% prevalence of diffuse hypoxic injury and a mean grey/white matter ratio of 1.1±0.1. Rate of donation in BD patients was 56%, with 39 donated organs: 23 kidneys, 12 livers, and 4 lungs. 89.74% of the transplanted organs reached an early good functional recovery. CONCLUSION In refractory CA patients treated with eCPR, the prevalence of BD is high. This population has a high potential for considering organ donation. Donated organs have a good outcome.
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Affiliation(s)
| | - Anna Coppo
- Cardiac Intensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST-Monza, Italy
| | - Alessia Vargiolu
- Neurointensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST-Monza, Italy
| | - Jacopo Villa
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Matteo Rota
- Neurointensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST-Monza, Italy
| | - Leonello Avalli
- Cardiac Intensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST-Monza, Italy
| | - Giuseppe Citerio
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; Neurointensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, ASST-Monza, Italy.
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A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: An observational study and propensity analysis. Resuscitation 2017; 117:109-117. [PMID: 28414164 DOI: 10.1016/j.resuscitation.2017.04.014] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/22/2017] [Accepted: 04/09/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies. METHODS We consecutively included refractory OHCA patients. In Period 1, ECPR was indicated in selected patients after 30min of advanced life support; in- or pre-hospital implementation depended on estimated transportation time and ECPR team availability. In Period 2, patient care relied on early ECPR initiation after 20min of resuscitation, stringent patient selection, epinephrine dose limitation and deployment of ECPR team with initial response team. Primary outcome was survival with good neurological function Cerebral Performance Category score (CPC score) 1 and 2 at ICU discharge or day 28. FINDINGS A total of 156 patients were included. (114 in Period 1 and 42 in Period 2). Baseline characteristics were similar. Mean low-flow duration was shorter by 20min (p<0.001) in Period 2. Survival was significantly higher in Period 2: 29% vs 8% (P<0.001), as confirmed by the multivariate analysis and propensity score. When combining stringent patient selection with an aggressive strategy, the survival rate increased to 38%. Pre-hospital ECPR implementation in itself was not an independent predictor of improved survival, but it was part of the strategy in Period 2. INTERPRETATION Our data suggest that ECPR in specific settings in the management of refractory OHCA is feasible and can lead to a significant increase in neurological intact survivors. These data, however, need to be confirmed by a large RCT.
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Barrett N. Post-arrest management. Qatar Med J 2017. [PMCID: PMC5474599 DOI: 10.5339/qmj.2017.swacelso.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Nicholas Barrett
- Department of Critical Care, Guy's and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
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Hutin A, Lamhaut L, Lidouren F, Kohlhauer M, Mongardon N, Carli P, Berdeaux A, Ghaleh B, Tissier R. Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs. J Am Heart Assoc 2016; 5:JAHA.116.004588. [PMID: 28007740 PMCID: PMC5210433 DOI: 10.1161/jaha.116.004588] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Extracorporeal cardiopulmonary resuscitation (ECPR) is widely proposed for the treatment of refractory cardiac arrest. It should be associated with coronary angiography if coronary artery disease is suspected. However, the prioritization of care remains unclear in this situation. Our goal was to determine whether coronary reperfusion should be instituted as soon as possible in such situations in a pig model. Methods and Results Anesthetized pigs were instrumented and submitted to coronary artery occlusion and ventricular fibrillation. After 5 minutes of untreated cardiac arrest, conventional cardiopulmonary resuscitation (CPR) was started. Fifteen minutes later, ECPR was initiated for a total duration of 240 minutes. Animals randomly underwent either early or late coronary reperfusion at 20 or 120 minutes of ECPR, respectively. This timing was adapted to the kinetic of infarct extension in pigs. Return of spontaneous circulation was determined as organized electrocardiogram rhythm with systolic arterial pressure above 80 mm Hg. During conventional CPR, hemodynamic parameters were not different between groups. Carotid blood flow then increased by 70% after the onset of ECPR in both groups. No animal (0 of 7) elicited return of spontaneous circulation after late reperfusion versus 4 of 7 after early reperfusion (P=0.025). The hemodynamic parameters, such as carotid blood flow, were also improved in early versus late reperfusion groups (113±20 vs 43±17 mL/min after 240 minutes of ECPR, respectively; P=0.030), along with infarct size decrease (71±4% vs 84±2% of the risk zone, respectively; P=0.013). Conclusions Early reperfusion improved hemodynamic status and facilitated return of spontaneous circulation in a porcine model of ischemic cardiac arrest treated by ECPR.
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Affiliation(s)
- Alice Hutin
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France.,Département d'Anesthésie Réanimation, Hôpital Universitaire Necker-Enfants Malades, SAMU de Paris, Université Paris Descartes-Paris V, Paris, France
| | - Lionel Lamhaut
- Département d'Anesthésie Réanimation, Hôpital Universitaire Necker-Enfants Malades, SAMU de Paris, Université Paris Descartes-Paris V, Paris, France
| | - Fanny Lidouren
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France
| | - Matthias Kohlhauer
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France
| | - Nicolas Mongardon
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France.,Service d'Anesthésie et des Réanimations Chirurgicales, Réanimation Chirurgicale Cardio-vasculaire, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Pierre Carli
- Département d'Anesthésie Réanimation, Hôpital Universitaire Necker-Enfants Malades, SAMU de Paris, Université Paris Descartes-Paris V, Paris, France
| | - Alain Berdeaux
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France
| | - Bijan Ghaleh
- Inserm, U955, Equipe 03, Créteil, France.,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France
| | - Renaud Tissier
- Inserm, U955, Equipe 03, Créteil, France .,Université Paris Est UMR_S955, DHU A-TVB, UPEC, Créteil, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est, Maisons-Alfort, France
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Benedek T, Popovici MM, Glogar D. Extracorporeal Life Support and New Therapeutic Strategies for Cardiac Arrest Caused by Acute Myocardial Infarction - a Critical Approach for a Critical Condition. ACTA ACUST UNITED AC 2016; 2:164-174. [PMID: 29967856 DOI: 10.1515/jccm-2016-0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/20/2016] [Indexed: 12/14/2022]
Abstract
This review summarizes the most recent developments in providing advanced supportive measures for cardiopulmonary resuscitation, and the results obtained using these new therapies in patients with cardiac arrest caused by acute myocardial infarction (AMI). Also detailed are new approaches such as extracorporeal cardiopulmonary resuscitation (ECPR), intra-arrest percutaneous coronary intervention, or the regional models for systems of care aiming to reduce the critical times from cardiac arrest to initiation of ECPR and coronary revascularization.
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Affiliation(s)
- Theodora Benedek
- University of Medicine and Pharmacy Tirgu Mures, Clinic of Cardiology, Tirgu Mures, Romania
| | - Monica Marton Popovici
- Swedish Medical Center, Department of Internal Medicine and Critical Care, Edmonds, Washington, USA
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Cornette J. Author's reply re: Microcirculation in women with severe pre-eclampsia and HELLP syndrome: a case control study. BJOG 2016; 123:1710-1. [PMID: 27531337 DOI: 10.1111/1471-0528.14046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Jérôme Cornette
- Department of Obstetrics & Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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