• Leonello Avalli, Elena Maggioni, Francesco Formica, Gianluigi Redaelli, Maurizio Migliari, Monica Scanziani, Simona Celotti, Anna Coppo, Rosa Caruso, Giuseppe Ristagno, and Roberto Fumagalli.
• Servizio di Anestesia e Rianimazione 1, U.O.S. Anestesia e Terapia intensiva CCH, Università Milano-Bicocca, Ospedale S.Gerardo, via Pergolesi 33, 20052 Monza, Italy. l.avalli@hsgerardo.org
• Resuscitation. 2012 May 1;83(5):579-83.

ObjectiveExtracorporeal membrane oxygenation (ECMO) support has been suggested to improve the survival rate in patients with refractory in- and out-of-hospital cardiac arrest (IHCA and OHCA). The aim of our study is to report our experience with ECMO in these patients.DesignRetrospective, single-centre, observational study.PatientsFrom January 2006 to February 2011 we studied 42 patients (31 males) with refractory cardiac arrest.Measurement And Main ResultsECMO implantation was successful in 38 (90%) of the 42 patients. ECMO support was positioned: three times (8%) in the operating room, six (16%) in the cardiac surgery intensive care unit, 21 (55%) in the emergency room, five (13%) in the catheterisation laboratory and three (8%) in the general ward. A total of 14 IHCA (58%) and three OHCA (16%) patients were weaned from ECMO (p<0.05). Eleven IHCA (46%) and one OHCA (5%, p<0.05) patients were discharged from intensive care unit (ICU). Among IHCA patients, 10 were alive at 6 months, nine of whom (38%) with good neurological outcome. Among OHCA patients weaned from ECMO, one was alive at 6 months with good neurological outcome (5%, p<0.05 vs. IHCA).ConclusionsECMO support should be considered as a resuscitation alternative in selected patients. More specifically, patients with witnessed IHCA benefit more from ECMO treatment compared to those who experience an out-of-hospital cardiac arrest.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

24 keywords...

hide…