Abstract
Background
Recent data identifies extracorporeal cardio-pulmonary resuscitation (eCPR) as a potential
addendum of conventional cardiopulmonary-resuscitation (cCPR) in highly specified
circumstances and selected patients. However, consented criteria indicating eCPR are
lacking. Therefore we provide first insights into the health-related quality of life
(HRQoL) outcomes of patients treated with eCPR in a real world setting.
Methods
Retrospective single-center experience of 60 consecutive patients treated with eCPR
between 01/2014 and 06/2016 providing 1-year survival- and HRQoL data obtained through
the Short-Form 36 Survey (SF-36) after refractory out-of-hospital- (OHCA) and in-hospital
cardiac arrest (IHCA) of presumed cardiac etiology.
Results
Resuscitation efforts until initiation of eCPR averaged 66 ± 35 min and 63.3% of the
patients suffered from OHCA. Fifty-five (91.7%) of the overall events were witnessed
and bystander-CPR was performed in 73.3% (n = 44) of cases. Cause of arrest was dominated
by acute myocardial infarction (AMI, 66.7%) and initial rhythm slightly outbalanced
by ventricular fibrillation/tachycardia (VF/VT 53.3%). 12-month survival was 31%.
Survivors experienced more often bystander-CPR (p = .001) and a shorter duration of
cCPR (p = .002). While mid-term survivors’ perceived HRQoL was compromised compared
to controls (p ≦ .0001 for PF, RP, RE and BP; p = .007 for GH; p = .016 for SF; p = .030 for MH; p = .108 for VT), scores however resembled HRQoL of subjects on
hemodialysis, following cardiogenic shock or pulmonary failure treated with extracorporeal
membrane oxygenation (ECMO).
Conclusions
While HRQoL scores of our survivors ranged markedly below controls, compared to patients
on chronic hemodialysis, following ECMO for cardiogenic shock or pulmonary failure
most of the discrepancies ameliorated. Thus, successfull eCPR in properly selected
patients does translate into an encouraging HRQoL approximating chronic renal failure.
Keywords
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Article info
Publication history
Published online: April 04, 2018
Accepted:
March 29,
2018
Received in revised form:
March 6,
2018
Received:
November 18,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.03.036.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
