Clinical outcomes in patients with acute hemodynamic collapse supported by extracorporeal life support

Although extracorporeal life support (ECLS) is utilized for acute hemodynamic collapse, clinical outcomes for such patients are uncertain. The present study examined 30-day clinical outcomes in patients treated with ECLS for acute hemodynamic collapse, and determined the factors associated with 30-day mortality in patients who required ECLS for cardiopulmonary arrest (CPA). A total of 200 patients, in whom emergency ECLS was utilized for acute hemodynamic collapse from 2006 to 2015, were analyzed retrospectively. The impact of CPA on all-cause 30-day death in the overall population was examined by multivariable logistic regression analysis; comparisons were made between 30-day survivors (n = 78) and non-survivors (n = 122). In addition, clinical factors associated with 30-day survival for patients in whom ECLS was utilized for CPA (n = 139) were examined. All-cause 30-day mortality in the overall study population was 61 % (122/200). CPA was the most common cause of ECLS requirement (70 %), and the factor associated strongest with death at 30-days (OR 3.31, 95 % CI 1.75-6.36, P < 0.01). Witnessed CPA with bystander cardiopulmonary resuscitation (CPR) (OR 4.33, 95 % CI 1.08-29.1, P = 0.04) and a less than 40 min interval between CPA and ECLS (OR 3.49, 95 % CI 1.39-9.02, P < 0.01) were suggested as factors associated with 30-day survival in CPA patients. CPA as a trigger of ECLS was a strong contributor to 30-day death in patients in whom emergency ECLS was utilized. However, witnessed CPA with bystander CPR and a less than 40 min interval from CPA to start of ECLS were suggested as factors associated with survival in these CPA patients.