A retrospective analysis of prognosis of adult cardiac arrest patients supported by extracorporeal membrane oxygen-ation
Objective:To analyze the influencing factors of adults receiving extracorporeal cardiopulmonary resuscitation(ECPR).Methods:A retrospective cohort study was conducted on 92 patients who were treated with ECPR in the Emergen-cy and Critical Care Center.Patients were divided into survival group(n=27)and death group(n=65)according to the clinical outcome.The basic data of the two groups and the relevant data before and after initiation of ECPR were analyzed.Results:The survival rate of 92 patients was 29.34％.At the beginning of extracorporeal membrane oxygenation(ECMO),the lactate level and the proportion of out-of-hospital cardiac arrest(OHCA)in the survival group were lower than those in the death group,and the pH and HCO3-levels in the survival group were higher than those in the death group(all P＜0.05).After initiation of ECMO,the proportion of patients with persistent hyperlactic acidemia,AST levels and ECPR time in the survival group were obviously reduced as compared with those in the death group,and the initial mean arterial pressure(MAP)in the survival group was obviously higher than that in the death group(all P＜0.05).Logistic regression analysis showed that ECPR time(OR=0.764,95％CI 0.63-0.927,P=0.006),initial MAP(OR=1.228,95％CI 1.026-1.470,P=0.025)were independent risk factors for ICU death in ECPR patients.Conclusions:The data show that ECPR is an ef-fective treatment for patients with cardiac arrest.The prognosis of ECPR is significantly related to the duration of ECPR and initial MAP＞66 mmHg.
Cardiac arrestExtracorporeal cardiopulmonary resuscitationAcidosisDuration of extracorporeal cardiop-ulmonary resuscitationMean arterial pressure
NETL
NSTL
万方数据
