Door-to-implantation time of extracorporeal life support systems predicts mortality in patients with out-of-hospital cardiac arrest

• Published in: Clinical research in cardiology 2013-09, Vol.102 (9), p.661-669
• Main Authors: Leick, Jürgen, Liebetrau, Christoph, Szardien, Sebastian, Fischer-Rasokat, Ulrich, Willmer, Matthias, van Linden, Arnaud, Blumenstein, Johannes, Nef, Holger, Rolf, Andreas, Arlt, Matthias, Walther, Thomas, Hamm, Christian, Möllmann, Helge
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cardiology; Cardiopulmonary Resuscitation - mortality; Chi-Square Distribution; Extracorporeal Membrane Oxygenation - adverse effects; Extracorporeal Membrane Oxygenation - instrumentation; Extracorporeal Membrane Oxygenation - mortality; Female; Hospital Mortality; Humans; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Original Paper; Out-of-Hospital Cardiac Arrest - diagnosis; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - physiopathology; Out-of-Hospital Cardiac Arrest - therapy; Patient Admission; Proportional Hazards Models; Recovery of Function; Retrospective Studies; Risk Factors; Stroke Volume; Survival Rate; Time Factors; Time-to-Treatment; Treatment Outcome; Ventricular Function, Left
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-013-0580-3

Objective This study aimed to identify predictors of mortality in patients with out-of-hospital cardiac arrest (OHCA) undergoing in-hospital extracorporeal life support system (ECLS) treatment. Methods We retrospectively studied the characteristics and clinical outcomes of 28 patients (January 2010 and December 2011) with OHCA and veno-arterial ECLS implemented during ongoing cardiopulmonary resuscitation (CPR) upon admission to the cath lab. Baseline left ventricular ejection fraction (LVEF) was determined after ECLS implantation and then every 24 h during and after successful weaning from ECLS. Results Overall 30-day survival rate was 39.3 % (11 of 28 patients). Baseline characteristics, initial laboratory measurements, and LVEF on admission were not significantly different between survivors and non-survivors. There was no difference regarding median CPR duration [survivors 44.0 min (IQR 31.0-45.0) vs. non-survivors 53.0 min (IQR 40.0-61.3); P  = 0.23]. Door-to-ECLS implantation time was significantly longer in non-survivors [42.5 min (IQR 28.0–56.5) vs. 25.0 min (IQR 21.0–30.0); P