ECMO vs Standard CPR in Cardiac Arrest
Pharmacy & Acute Care University
Elevating the practice of every healthcare students and professionals to provide safe care for critically ill patients.
In the detailed analysis by Low et al., published in Critical Care (2024), the focus is on comparing ECPR's effectiveness to CCPR in cardiac arrest cases, specifically highlighting its impact on out-of-hospital cardiac arrest (OHCA) scenarios.
The study includes a substantial sample, with 6336 patients undergoing ECPR and 7712 receiving CCPR. The primary outcome being in-hospital mortality. Secondary outcomes included short- and long-term favourable neurological outcome and survival (30 days-1 year).
Results
ECPR was associated with greater precision in reducing overall in-hospital mortality (OR 0.63, 95% CI 0.50-0.79). The addition of recent studies revealed a newly significant decrease in mortality in OHCA (OR 0.62, 95% CI 0.45-0.84). Also, there was a favourable short-term neurological outcomes and survival up to 30 days. No difference was found with long-term neurological outcome and 90-day-1-year survival.
Implications
The implications for EDs and ICUs include considering ECPR for cardiac arrest cases, given its association with reduced mortality and improved outcomes, especially in out-of-hospital scenarios. This suggests a potential shift in resuscitation protocols and training in these critical care settings to incorporate ECPR where feasible.
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