Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes

9 p.

Detalles Bibliográficos
Autores: Ortega Deballón, Iván María|||0000-0002-0819-2399, Hornby, Laura, Shemie, Sam D., Bhanjih, Farhan, Guadagno, Elena
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universidad de Alcalá (UAH)
Repositorio:e_Buah Biblioteca Digital Universidad de Alcalá
Idioma:inglés
OAI Identifier:oai:ebuah.uah.es:10017/59998
Acceso en línea:http://hdl.handle.net/10017/59998
https://dx.doi.org/10.1016/j.resuscitation.2016.01.018
Access Level:acceso abierto
Palabra clave:Anoxic brain injury
Cardiopulmonary resuscitation
Deceased organ donation
Extracorporeal resuscitation
Out-of-hospital cardiac arrest
Refractory cardiac arrest
Enfermeria
Nursery
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spelling Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomesOrtega Deballón, Iván María|||0000-0002-0819-2399Hornby, LauraShemie, Sam D.Bhanjih, FarhanGuadagno, ElenaAnoxic brain injuryCardiopulmonary resuscitationDeceased organ donationExtracorporeal resuscitationOut-of-hospital cardiac arrestRefractory cardiac arrestEnfermeriaNursery9 p.Aim: Extracorporeal resuscitation during cardiopulmonary resuscitation (ECPR) deploys rapid cardiopulmonary bypass to sustain oxygenated circulation until the return of spontaneous circulation (ROSC). The purpose of this systematic review is to address the defining elements and outcomes (quality survival and organ donation) of currently active protocols for ECPR in refractory out-of-hospital cardiac arrest (OHCA) of cardiac origin in adult patients. The results may inform policy and practices for ECPR and help clarify the corrresponding intersection with deceased organ donation. Methods: We searched Medline, Embase, Cochrane and seven other electronic databases from 2005 to 2015, with no language restrictions. Internal validity and the quality of the studies reporting outcomes and guidelines were assessed. The review was included in the international prospective register of systematic reviews (Prospero, CRD42014015259). Results: One guideline and 20 outcome studies were analyzed. Half of the studies were prospective observational studies assessed to be of fair to good methodological quality. The remainder were retrospective cohorts, case series, and case studies. Ages ranged from 16 to 75 years and initial shockable cardiac rhythms, witnessed events, and a reversible primary cause of cardiac arrest were considered favorable prognostic factors. CPR duration and time to hospital cannulation varied considerably. Coronary revascularization, hemodynamic interventions and targeted temperature management neuroprotection were variable. A total of 833 patients receiving this ECPR approach had an overall reported survival rate of 22%, including 13% with good neurological recovery. Additionally, 88 potential and 17 actual deceased organ donors were identified among the non-survivor population in 8 out of 20 included studies. Study heterogeneity precluded a meta-analysis preventing any meaningful comparison between protocols, interventions and outcomes. Conclusions: ECPR is feasible for refractory OHCA of cardiac origin in adult patients. It may enable neurologically good survival in selected patients, who practically have no other alternative in order to save their lives with quality of life, and contribute to organ donation in those who die. Large, prospective studies are required to clarify patient selection, modifiable outcome variables, risk-benefit and cost-effectiveness.20162016-04-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10017/59998https://dx.doi.org/10.1016/j.resuscitation.2016.01.018reponame:e_Buah Biblioteca Digital Universidad de Alcaláinstname:Universidad de Alcalá (UAH)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ebuah.uah.es:10017/599982026-06-18T11:13:07Z
dc.title.none.fl_str_mv Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
title Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
spellingShingle Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
Ortega Deballón, Iván María|||0000-0002-0819-2399
Anoxic brain injury
Cardiopulmonary resuscitation
Deceased organ donation
Extracorporeal resuscitation
Out-of-hospital cardiac arrest
Refractory cardiac arrest
Enfermeria
Nursery
title_short Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
title_full Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
title_fullStr Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
title_full_unstemmed Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
title_sort Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes
dc.creator.none.fl_str_mv Ortega Deballón, Iván María|||0000-0002-0819-2399
Hornby, Laura
Shemie, Sam D.
Bhanjih, Farhan
Guadagno, Elena
author Ortega Deballón, Iván María|||0000-0002-0819-2399
author_facet Ortega Deballón, Iván María|||0000-0002-0819-2399
Hornby, Laura
Shemie, Sam D.
Bhanjih, Farhan
Guadagno, Elena
author_role author
author2 Hornby, Laura
Shemie, Sam D.
Bhanjih, Farhan
Guadagno, Elena
author2_role author
author
author
author
dc.subject.none.fl_str_mv Anoxic brain injury
Cardiopulmonary resuscitation
Deceased organ donation
Extracorporeal resuscitation
Out-of-hospital cardiac arrest
Refractory cardiac arrest
Enfermeria
Nursery
topic Anoxic brain injury
Cardiopulmonary resuscitation
Deceased organ donation
Extracorporeal resuscitation
Out-of-hospital cardiac arrest
Refractory cardiac arrest
Enfermeria
Nursery
description 9 p.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-04-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10017/59998
https://dx.doi.org/10.1016/j.resuscitation.2016.01.018
url http://hdl.handle.net/10017/59998
https://dx.doi.org/10.1016/j.resuscitation.2016.01.018
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:e_Buah Biblioteca Digital Universidad de Alcalá
instname:Universidad de Alcalá (UAH)
instname_str Universidad de Alcalá (UAH)
reponame_str e_Buah Biblioteca Digital Universidad de Alcalá
collection e_Buah Biblioteca Digital Universidad de Alcalá
repository.name.fl_str_mv
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