초록접수 현황
| 16F-051 | 구연 발표 |
Therapeutic Hypothermia May Not Improve Neurologic and Survival Outcomes in Extracorporeal Cardiopulmonary Resuscitation
Young Su Kim, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang, Young Tak Lee
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : Not only therapeutic hypothermia (TH) but also extracorporeal cardiopulmonary resuscitation (ECPR) is known to be an important treatment for organ protection during cardiopulmonary arrest, but the impact on clinical outcomes of combining TH and ECPR has not been well studied. So, we reviewed our experience of ECPR and investigated the effect of TH on clinical outcome.
Methods : We reviewed 245 patients who received extracorporeal life support (ECLS) between January 2012 and June 2015 at Samsung Medical Center. Exclusion criteria were ECLS performed for reasons other than cardiac arrest, age less than 18 years, and death within 24 hours. A total of 101 patients were included for the study. Twenty-five patients underwent therapeutic hypothermia (TH) and 76 patients did not (non-TH). Primary endpoints were survival to discharge. And we use multivariate analysis for finding predictors of hospital survival.
Results : Patients in non-TH group had mostly in-hospital cardiac arrest (93%). They had more diabetes mellitus, coronary disease, and stroke than patients in TH group. Other baseline characteristics including age, sex, chronic kidney disease, etiology of cardiac arrest, and cardiac arrest time were similar between both groups. There was significant difference in body temperature during first 24 hours after ECPR (p=0.001). Overall hospital survival and favorable neurologic outcome rates were 47% and 34% respectively. There was no difference in terms of hospital survival and favorable neurologic outcome between two groups (p=0.909 and 0.841, respectively). Although young age and short CPR time were predictors of hospital survival (p=0.042, <0.001 respectively), TH was not related to hospital survival.
Conclusion : We could not find favorable impact of TH in ECPR patients. Further study may be needed to refine the role of TH in ECPR.
Methods : We reviewed 245 patients who received extracorporeal life support (ECLS) between January 2012 and June 2015 at Samsung Medical Center. Exclusion criteria were ECLS performed for reasons other than cardiac arrest, age less than 18 years, and death within 24 hours. A total of 101 patients were included for the study. Twenty-five patients underwent therapeutic hypothermia (TH) and 76 patients did not (non-TH). Primary endpoints were survival to discharge. And we use multivariate analysis for finding predictors of hospital survival.
Results : Patients in non-TH group had mostly in-hospital cardiac arrest (93%). They had more diabetes mellitus, coronary disease, and stroke than patients in TH group. Other baseline characteristics including age, sex, chronic kidney disease, etiology of cardiac arrest, and cardiac arrest time were similar between both groups. There was significant difference in body temperature during first 24 hours after ECPR (p=0.001). Overall hospital survival and favorable neurologic outcome rates were 47% and 34% respectively. There was no difference in terms of hospital survival and favorable neurologic outcome between two groups (p=0.909 and 0.841, respectively). Although young age and short CPR time were predictors of hospital survival (p=0.042, <0.001 respectively), TH was not related to hospital survival.
Conclusion : We could not find favorable impact of TH in ECPR patients. Further study may be needed to refine the role of TH in ECPR.
책임저자: Ji-Hyuk Yang
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Yang Hyun Cho, E-mail : yanghyun.cho@samsung.com