A novel extracorporeal cardiopulmonary resuscitation strategy using a hybrid emergency room for patients with pulseless electrical activity

被引：12

作者：

Ijuin, Shinichi ^{[1
]}

Inoue, Akihiko ^{[1
]}

Ishihara, Satoshi ^{[1
]}

Suga, Masafumi ^{[1
]}

Nishimura, Takeshi ^{[1
]}

Kikuta, Shota ^{[1
]}

Nakayama, Haruki ^{[1
]}

Igarashi, Nobuaki ^{[2
]}

Matsuyama, Shigenari ^{[1
]}

Doi, Tomofumi ^{[2
]}

Nakayama, Shinichi ^{[1
]}

机构：

[1] Hyogo Emergency Med Ctr, Dept Emergency & Crit Care Med, Chuo Ku, 1-3-1 Wakinohamakaigandori, Kobe, Hyogo 6510073, Japan

[2] Japanese Red Cross Kobe Hosp, Dept Cardiol, Chuo Ku, 1-3-1 Wakinohamakaigandori, Kobe, Hyogo 6510073, Japan

来源：

SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE | 2022年 / 30卷 / 01期

关键词：

Extracorporeal cardiopulmonary resuscitation; Hybrid emergency room; Pulseless electrical activity; Pulmonary embolism; Aortic disease; Intracranial haemorrhage; HOSPITAL CARDIAC-ARREST; PULMONARY-EMBOLISM; GUIDELINES;

D O I：

10.1186/s13049-022-01024-2

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background Whether extracorporeal cardiopulmonary resuscitation (ECPR) is indicated for patients with pulseless electrical activity (PEA) remains unclear. Pulmonary embolism with PEA is a good candidate for ECPR; however, PEA can sometimes include an aortic disease and intracranial haemorrhage, with extremely poor neurological outcomes, and can thus not be used as a suitable candidate. We began employing an ECPR strategy that utilised a hybrid emergency room (ER) to perform computed tomography (CT) before extracorporeal membrane oxygenation (ECMO) induction from January 2020. Therefore, the present study aimed to evaluate the effectiveness of this ECPR strategy. Methods Medical records of patients who transferred to our hybrid ER and required ECPR for PEA between January 2020 and November 2021 were reviewed. Results Twelve consecutive patients (median age, 67 [range, 57-73] years) with PEA requiring ECPR were identified in our hybrid ER. Among these patients, nine were diagnosed using an initial CT scan (intracranial haemorrhage (3); cardiac tamponade due to aortic dissection (3); aortic rupture (2); and cardiac rupture (1)), and unnecessary ECMO was avoided. The remaining three patients underwent ECPR, and two of them survived with favourable neurological outcomes. Patients not indicated for ECPR were excluded before ECMO induction. Conclusion Our ECPR strategy that involved the utilisation of a hybrid ER may be useful for the exclusion of patients with PEA not indicated for ECPR and decision making.

引用

页数：6

共 23 条

[1] Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia [J].