• Critical care medicine · Apr 2024

    Multicenter Study Comparative Study

    Higher Survival With the Use of Extracorporeal Cardiopulmonary Resuscitation Compared With Conventional Cardiopulmonary Resuscitation in Children Following Cardiac Surgery: Results of an Analysis of the Get With The Guidelines-Resuscitation Registry.

    • Ryan L Kobayashi, Kimberlee Gauvreau, AlexanderPeta M APMADepartments of Cardiology & Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA., Sarah A Teele, Francis Fynn-Thompson, Javier J Lasa, Melania Bembea, Ravi R Thiagarajan, and American Heart Association’s (AHA) Get With The Guidelines-Resuscitation (GWTG-R) Investigators.
    • Departments of Cardiology & Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
    • Crit. Care Med. 2024 Apr 1; 52 (4): 563573563-573.

    ObjectivesExtracorporeal membrane oxygenation to support cardiopulmonary resuscitation (CPR) is increasingly used in children suffering cardiac arrest after cardiac surgery. However, its efficacy in promoting survival has not been evaluated. We compared survival of pediatric cardiac surgery patients suffering in-hospital cardiac arrest who were resuscitated with extracorporeal CPR (E-CPR) to those resuscitated with conventional CPR (C-CPR) using propensity matching.DesignRetrospective study using multicenter data from the American Heart Association Get With The Guidelines-Resuscitation registry (2008-2020).SettingMulticenter cardiac arrest database containing cardiac arrest and CPR data from U.S. hospitals.PatientsCardiac surgical patients younger than 18 years old who suffered in-hospital cardiac arrest and received greater than or equal to 10 minutes of CPR.InterventionsNone.Measurements And Main ResultsAmong 1223 patients, 741 (60.6%) received C-CPR and 482 (39.4%) received E-CPR. E-CPR utilization increased over the study period ( p < 0.001). Duration of CPR was longer in E-CPR compared with C-CPR recipients (42 vs. 26 min; p < 0.001). In a propensity score matched cohort (382 E-CPR recipients, 382 C-CPR recipients), E-CPR recipients had survival to discharge (odds ratio [OR], 2.22; 95% CI, 1.7-2.9; p < 0.001). E-CPR survival was only higher when CPR duration was greater than 18 minutes. Propensity matched analysis using patients from institutions contributing at least one E-CPR case ( n = 35 centers; 353 E-CPR recipients, 353 C-CPR recipients) similarly demonstrated improved survival in E-CPR recipients compared with those who received C-CPR alone (OR, 2.08; 95% CI, 1.6-2.8; p < 0.001).ConclusionsE-CPR compared with C-CPR improved survival in children suffering cardiac arrest after cardiac surgery requiring CPR greater than or equal to 10 minutes.Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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