title: Resuscitative extracorporeal membrane oxygenation for in hospital cardiac arrest: a Canadian observational experience.
abstract: BACKGROUND
  Among patients with reversible conditions who sustain cardiac arrest, extracorporeal membrane oxygenation (ECMO) may support end organ perfusion while bridging to definitive therapy.
  
  
  METHODS
  A single center retrospective review (February 2008–September 2013) of adults receiving ECMO for cardiac arrest ≥15 min duration refractory to conventional management (E-CPR) or profound cardiogenic shock following IHCA (E-CS) was conducted. The primary outcome was 30-day survival with good neurologic function defined as a cerebral performance category (CPC) of 1–2. Secondary outcomes included intensive care unit (ICU) and hospital length of say, duration of mechanical ventilation, and univariate predictors of 30-day survival with favorable neurologic function.
  
  
  RESULTS
  Thirty-two patients (55 ± 11 years, 66% male) were included of which 22 (69%) received E-CPR and 10 (31%) received E-CS following return of spontaneous circulation (ROSC). Cardiac arrest duration was 48.8 ± 21 min for those receiving E-CPR and 25 ± 23 min for the E-CS group. Patients received ECMO support for 70.7 ± 47.6 h. Death on ECMO support occurred in 7 (21.9%) patients, while 7 (21.9%) were bridged to another form of mechanical circulatory support, and 18 (56.3%) were successfully decannulated. ICU length of stay was 7.5 [3.3–14] days and ICU survival occurred in 16 (50%) of patients. 30-Day survival was 5 (50%) in the E-CS group, 10 (45.4%) in the E-CPR group, and 15 (47%) overall. All survivors had CPC 1–2 neurologic status.
  
  
  CONCLUSIONS
  In this single center experience, the use of resuscitative ECMO was associated with neurologically favorable 30-day survival in 47% of patients with prolonged IHCA (H2012:172).
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Bednarczyk
authors.forename: Christopher W
authors.initials: CW
authors.lastname: White
authors.forename: Robin A
authors.initials: RA
authors.lastname: Ducas
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Golian
authors.forename: Roman
authors.initials: R
authors.lastname: Nepomuceno
authors.forename: Brett
authors.initials: B
authors.lastname: Hiebert
authors.forename: Derek
authors.initials: D
authors.lastname: Bueddefeld
authors.forename: Rizwan A
authors.initials: RA
authors.lastname: Manji
authors.forename: Rohit K
authors.initials: RK
authors.lastname: Singal
authors.forename: Farrukh
authors.initials: F
authors.lastname: Hussain
authors.forename: Darren H
authors.initials: DH
authors.lastname: Freed
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome