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Survival and Outcomes After Cardiac Arrest With VA-ECMO Rescue Therapy
James W Schurr1, Mohammad Noubani, Lee Ann Santore
1ECMO Research Group, Division of Cardiothoracic Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York.
Shock (Augusta, Ga.)
|May 14, 2021
Summary
Extracorporeal membrane oxygenation (ECMO) can improve survival in cardiac arrest patients. Lower BMI and shorter CPR duration predict better outcomes, while the modified SAVE (mSAVE) score effectively predicts survival and neurological function.
Area of Science:
- Cardiology
- Critical Care Medicine
- Extracorporeal Life Support
Background:
- Extracorporeal membrane oxygenation (ECMO) use is rising for cardiac arrest patients.
- Utilization varies, with centers employing it as rescue therapy or early protocolized extracorporeal cardiopulmonary resuscitation.
Purpose of the Study:
- Evaluate survival and neurological outcomes in cardiac arrest patients treated with ECMO.
- Validate the SAVE and modified SAVE (mSAVE) scores.
- Identify predictors of outcomes in ECMO rescue therapy.
Main Methods:
- Retrospective analysis of 89 cardiac arrest patients receiving ECMO support (2011-2019).
- Assessed survival, non-neurologic, and neurologic outcomes.
- Validated SAVE and mSAVE scores and identified predictive factors.
Main Results:
- In-hospital survival was 38.2%.
- Survivors had lower BMI, less obesity, shorter CPR duration, more tracheostomies, and less renal replacement therapy (RRT).
- The mSAVE score predicted survival and favorable neurologic outcomes; BMI was also a key predictor.
Conclusions:
- The modified SAVE (mSAVE) score, BMI, RRT, and tracheostomy predict in-hospital survival.
- mSAVE and BMI predict favorable neurologic outcomes in cardiac arrest patients receiving ECMO.