The following is a summary of “Survival after extracorporeal cardiopulmonary resuscitation based on in-hospital cardiac arrest and cannulation location: An analysis of the extracorporeal life support organization registry,” published in the October 2024 issue of Critical Care by Mazzeffi et al.
Researchers conducted a retrospective study to explore variations in Extracorporeal Cardiopulmonary Resuscitation (ECPR) mortality based on in-hospital cardiac arrest location and the impact of patient movement for cannulation on outcomes.
They performed a study at ECPR hospitals that reported data to the Extracorporeal Life Support Organization (ELSO), which included patients who underwent ECPR for in-hospital cardiac arrest between 2020 and 2023. The patient demographics, comorbidities, pre-cardiac arrest conditions, pre-ECPR vasopressor use, details of the cardiac arrest, ECPR cannulation information, significant complications, and in-hospital mortality were documented. A multivariable logistic regression model was employed to analyze the associations between in-hospital mortality, the location of cardiac arrest, and the transfer of a patient for ECPR cannulation.
The results showed that 2,515 patients met the criteria. The adjusted odds ratio (aOR) for mortality was increased in patients who had a cardiac arrest in the ICU (aOR, 1.85; 95% CI, 1.45–2.38; P < 0.001) and in patients who had a cardiac arrest in an acute care bed (aOR, 1.68; 95% CI, 1.09–2.58; P = 0.02) compared with the cardiac catheterization laboratory. Moving a patient for cannulation had no association with mortality (aOR, 0.70; 95% CI, 0.18–2.81; P = 0.62). Advanced patient age was related to increased mortality. Specifically, patients aged 60–69 and 70 years old or older were more likely to die compared with patients younger than 30 years old (aOR, 1.71; 95% CI, 1.17–2.50; P = 0.006 and aOR, 2.27; 95% CI, 1.49–3.48; P < 0.001, respectively).
They concluded that patients with ECPR who experienced cardiac arrest in the ICU and in acute care hospital beds had increased odds of mortality compared to other locations, and transferring patients for ECPR cannulation did not lead to improved outcomes.
Source: journals.lww.com/ccmjournal/abstract/9900/survival_after_extracorporeal_cardiopulmonary.388.aspx
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