Outcome of in-hospital adult cardiopulmonary resuscitation assisted with portable auto-priming percutaneous cardiopulmonary support.
BACKGROUND
Outcome from in-hospital cardiopulmonary resuscitation (CPR) is still unsatisfactory. CPR assisted with percutaneous cardiopulmonary support (PCPS) is expected to improve the outcome of in-hospital CPR.


METHODS
We retrospectively analyzed 83 consecutive cases of adult in-hospital CPR assisted by a portable pre-assembled auto-priming PCPS system (EBS, Terumo, Japan) from January 2004 to December 2007.


RESULTS
PCPS was successfully performed in 97.6% of the patients and could be weaned in 57.8% of the patients. The survival-to-discharge rate was 41.0% with an acceptable neurological status in 85.3% of the patients. The 6-month survival was 38.6%. Survival-to-discharge decreased about 1% for each 1 min increase in the duration of CPR. The probability of survival was about 65%, 45%, and 19% when the duration of CPR was 10, 30, or 60 min, respectively. Multivariate analysis adjusted with clinical factors including organ dysfunction severity scores revealed that defibrillation and CPR duration less than 35 min were independent predictors for both survival-to-discharge (odds ratio=8.0, 95% CI=2.8-23.0, p<0.001) and 6-month survival (hazard ratio=3.3, 95% CI=1.9-5.9, p<0.001).


CONCLUSIONS
Our results showed that CPR assisted with PCPS results in an acceptable survival-to-discharge rate and mid-term prognosis.
Jo
Ik Joon
IJ
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Shin
Tae Gun
TG
Sim
Min Sub
MS
Song
Hyoung Gon
HG
Jeong
Yeon Kwon
YK
Song
Yong-Bien
YB
Hahn
Joo-Yong
JY
Choi
Seung Hyuk
SH
Gwon
Hyeon-Cheol
HC
Jeon
Eun-Seok
ES
Kim
Wook Sung
WS
Lee
Young Tak
YT
Sung
Kiick
K
Choi
Jin-Ho
JH
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000401:mortality*; D015897:Comorbidity; D004867:Equipment Design; D005112:Extracorporeal Circulation / Q000295:instrumentation / Q000401:mortality*; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome