An integrated program of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation and uncontrolled donation after circulatory determination of death in refractory cardiac arrest

• Tipo: Artigo em Revista Científica Internacional
• Data: 2018

Autores

Roncon-Albuquerque R Jr (Autor) FMUP; Sergio Gaiao (Autor) FMUP; Araújo JP (Autor) FMUP; Principe, N (Autor) Outra; Basilio, C (Autor) Outra; Mergulhao, P (Autor) FMUP; Silva, S (Autor) Outra; Honrado, T (Autor) Outra; Francisco Cruz (Autor) FMUP; Pestana M (Autor) FMUP; José Oliveira (Autor) FMUP; Meira, L (Autor) Outra; Franca, A (Autor) Outra; Almeida Sousa, JP (Autor) Outra; araujo, f (Autor) FMUP; Paiva, J-A (Autor) FMUP

Revista

Título: Resuscitation

Vol. 133

Páginas: 88-94

ISSN: 0300-9572

Editora: Elsevier

Indexação

ISI Web of Knowledge - 31 Citações

Scopus - 33 Citações

Outras Informações

ID Authenticus: P-00P-RCM

DOI: 10.1016/j.resuscitation.2018.10.016

Abstract (EN): Aim: To assess the feasibility of an integrated program of extracorporeal cardiopulmonary resuscitation (ECPR) and uncontrolled donation after circulatory determination of death (uDCDD) in refractory cardiac arrest (rCA). Methods: Single center, prospective, observational study of selected patients with in-hospital (IHCA) and out-of-hospital (OHCA) rCA occurring in an urban area of similar to 1.5 million inhabitants, between October-2016 and May-2018. 65 year old or younger patients without significant bleeding or comorbidities with witnessed nonasystolic cardiac arrests were triaged to ECPR if they had a reversible cause and high quality CPR lasting < 60 min. Otherwise they were considered for uDCDD after a ten minute no touch period using normothermic regional perfusion. Results: 58 patients were included, of which 41 (71%) were OHCA and 18 (31%) had ECPR initiated. Median age was 52 (IQR 45-56) years. Cannulation was successful in 49/58 (84%) cases. Compared to ECPR, patients referred for uDCDD were more frequently OHCA (90 vs. 28%), had bystander CPR (28 vs. 83%) and prolonged low-flow period (40 (35-50) vs. 60 (49-78) min). Survival to hospital discharge with full neurological recovery (cerebral performance category 1) occurred in 6/18 (33%) ECPR patients. uDCDD resulted in transplantation of 44 kidneys. Conclusions: An integrated program for rCA consisting of a formal pathway to uDCDD referral in ECPR ineligible patients is feasible. ECPR-referred patients had a reasonable survival with full neurologic recovery. Successful kidney transplantation was achieved with uDCDD.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 7