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Coronary lesions in refractory out of hospital cardiac arrest (OHCA) treated by extra corporeal pulmonary resuscitation (ECPR)

التفاصيل البيبلوغرافية
العنوان: Coronary lesions in refractory out of hospital cardiac arrest (OHCA) treated by extra corporeal pulmonary resuscitation (ECPR)
المؤلفون: Romain Jouffroy, Christian Spaulding, Lionel Lamhaut, Xavier Jouven, Kim An, Victoria Tea, Albert Hagège, Pierre Carli, C. Dagron, Jean-Herlé Raphalen, Alice Hutin, Frédéric J. Baud, Nicolas Danchin, Alain Cariou, Etienne Puymirat
المصدر: Resuscitation. 126
سنة النشر: 2017
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Emergency Medical Services, medicine.medical_treatment, Comorbidity, Coronary Artery Disease, 030204 cardiovascular system & hematology, Emergency Nursing, Revascularization, Coronary Angiography, Out of hospital cardiac arrest, Time-to-Treatment, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, Refractory, Statistical significance, Internal medicine, medicine, Humans, Extracorporeal cardiopulmonary resuscitation, Prospective Studies, Aged, business.industry, Percutaneous coronary intervention, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Cardiopulmonary Resuscitation, Cohort, Emergency Medicine, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest
الوصف: Purpose Extracorporeal cardiopulmonary resuscitation (ECPR) is a second line treatment for refractory cardiac arrest (R-OHCA). Timing of ECPR before performing coronary angiography (CAG) is still debated. The aim of the study was to describe the clinical and angiographic characteristics of the largest cohort of out-of-hospital cardiac arrest (OHCA) patients undergoing ECPR. Methods All refractory OHCA patients with ECPR managed by the prehospital mobile intensive care unit (MoICU of the SAMU) in Paris (France) were prospectively included from October 2014 to December 2016. Results Among 74 patients included over the period, 54 patients had coronary artery disease (CAD). There is a trend toward the CAD patients being older but it did not meet statistical significance (55.3 ± 11.8 vs. 50.6 ± 12.8, p = 0,14). Patients were more frequently men and smokers (p = 0.03 for both). The proportion of initial shockable rhythm tended to be higher in patients with CAD (71% vs. 55%). The rate of 1-, 2-, and 3-vessel disease were 43%, 35% and 22% respectively. The Syntax Score was 18 ± 9 and the lesions in each epicardial vessel were mainly proximal. Percutaneous coronary intervention was performed ad hoc in 49 patients (91%). Complete revascularization was performed in 64%. Inhospital death was numerically lower (65% vs. 75%) in patients with CAD, especially in patients with initial shockable rhythm. Conclusion In 74 refractory OHCA patients treated with ECPR implanted by a prehospital mobile intensive care unit, the rate of CAD was high (54/74) especially in patients with shockable rhythm. The majority of patients presented with double or triple vessel disease and proximal lesions. The severity and extension of CAD may explain the refractory nature of the cardiac arrest.
تدمد: 1873-1570
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::70a377ec392dbdd591a70909916cc24c
https://pubmed.ncbi.nlm.nih.gov/29253646
Rights: CLOSED
رقم الانضمام: edsair.doi.dedup.....70a377ec392dbdd591a70909916cc24c
قاعدة البيانات: OpenAIRE
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