The incidence of "load&go" out-of-hospital cardiac arrest candidates for emergency department utilization of emergency extracorporeal life support: A one-year review. (June 2015)

• Record Type: Journal Article
• Authors: Poppe, Michael; Weiser, Christoph; Holzer, Michael; Sulzgruber, Patrick; Datler, Philip; Keferböck, Markus; Zeiner, Sebastian; Lobmeyr, Elisabeth; van Tulder, Raphael; Ziegler, Andreas; Glück, Harald; Meixner, Manfred; Schrattenbacher, Georg; Maszar, Henrik; Zajicek, Andreas; Sterz, Fritz; Schober, Andreas
• Is Part Of: Resuscitation. Volume 91(2015)
• Page Start: 131
• Page End: 136
• Publication Date: 2015-06
• Subjects: Cardiopulmonary resuscitation -- Out-of-hospital cardiac arrest -- Extracorporeal membrane oxygenation; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2015.03.003
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Background: The outcome of patients after out-of-hospital cardiac arrest (OHCA) is poor and gets worse after prolonged resuscitation. Recently introduced attempts like an early installed emergency extracorporeal life support (E-ECLS) in patients with persisting cardiac arrest at the emergency department (ED) are tried. The "Vienna Cardiac Arrest Registry" (VICAR) was introduced August 2013 to collect Utstein-style data. The aim of this observational study was to identify the incidence of patients which fulfil "load&go"-criteria for E-ECLS at the ED. Methods: VICAR was retrospectively analyzed for following criteria: age <75 years; witnessed OHCA; basic life support; ventricular fibrillation/ventricular tachycardia; no return-of-spontaneous-circulation (ROSC) within 15 min of advanced-life-support, which were supposed as potential optimal criteria for "load&go" plus successful E-ECLS treatment at the ED. The observation period was from August 1, 2013 to July 31, 2014. Results: Over 948 OHCA patients registered during the study period; data were exploitable for 864 patients. Of all patients, "load&go"-criteria were fulfilled by 55 (6%). However, 96 (11%) were transported with on-going CPR to the ED. Of these 96 patients, only 16 (17%) met the "load&go"-criteria. Similarly, among the 96 patients, 12 adults were treated with E-ECLS at the ED, with only 5 meeting the criteria. Among these 12 patients, favourable neurological outcome (CPC 1/2) was obtained in 1 patient without criteria. Conclusion: Further promotion of these criteria within the ambulance crews is needed. May be these criteria could serve as a decision support for emergency physicians/paramedics, which patients to transport with on-going CPR to the ED for E-ECLS.