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Ice Water Drowning Survival After 147-Minute Submersion and 7 °C Hypothermic Circulatory Arrest

Abstract Background Young patients may survive accidental deep hypothermia with prolonged asystolic circulatory arrest because of protective effects of cold. Case Summary An 8-year-old boy fell through pond ice and..

Lee mas
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Implementing lean six sigma to optimize emergency extracorporeal cardiopulmonary resuscitation process management

Abstract Objective The aim of this study is to evaluate the effectiveness of lean six sigma management in optimizing the emergency extracorporeal cardiopulmonary resuscitation (ECPR) rescue process. Methods The existing..

Lee mas
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Extracorporeal CPR Performance Metrics in Adult In-Hospital Cardiac Arrest: A Stepwise and Evidence-Based Appraisal of the VA-ECMO Implementation Process

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an established intervention for select patients experiencing refractory cardiac arrest. Among modifiable predictors of survival and neurologic recovery during ECPR implementation, timely restoration of..

Lee mas
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Incidence, Risk Factors, and Outcomes of Seizures in Extracorporeal Cardiopulmonary Resuscitation Patients: An Analysis of the Extracorporeal Life Support Organization…

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest is increasing in usage, but risk factors for seizures are largely unknown. We included adult ECPR patients in the Extracorporeal Life..

Lee mas
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Delayed neurological recovery in patients after extracorporeal resuscitation compared to conventional resuscitation. Implications for outcome assessment after cardiac arrest

Abstract Introduction Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for refractory cardiac arrest, with evidence suggesting improved outcomes when performed at experienced centres. Unlike conventional CPR (cCPR), eCPR patients..

Lee mas
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Is it Time to Upgrade Neuromonitoring in ECPR Recipients to Evaluate Cerebral Perfusion Imbalances Adequately?

Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) brings many monitoring pitfalls due to the countercurrent blood flow, which may create left ventricular overload and perfusion imbalances between the two cerebral hemispheres...

Lee mas
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Exploring the Association Between Early PaCO2 Correction Speed and Cerebrovascular Autoregulation in a Porcine Model of Extracorporeal Resuscitation

Abstract Background Prior clinical research demonstrated that rapid reduction in arterial carbon dioxide (PaCO2) levels during extracorporeal membrane oxygenation (ECMO) is associated with acute brain injury (ABI), which may be..

Lee mas
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Immediate post-ECPR management strategies in the prehospital and critical care transport medicine environments

Abstract Despite advancements in care, out-of-hospital cardiac arrest has a low survival rate. Extracorporeal cardiopulmonary resuscitation (ECPR) has shown improved outcomes in select cases, notably in the ARREST trial. However,..

Lee mas
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The cost-effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest: A Systematic Review

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest across the world, but its cost-effectiveness remains uncertain. We conducted this systematic review to assess the available..

Lee mas
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Extracorporeal Cardiopulmonary Resuscitation: Reviewing the Evidence and Exploring Its Equitable Implementation in the UK National Health Service

Abstract Cardiac arrest outcomes remain historically poor with survival to hospital discharge less than 2.2% in the UK (). Refractory cardiac arrest is characterized by a persistent loss of circulation..

Lee mas
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Extracorporeal and Conventional Cardiopulmonary Resuscitation and Low‐Flow Duration: Insights From a Nationwide Hospital‐Based Registry Study in Japan (JAAM‐OHCA Registry)

Abstract Background The optimal low‐flow duration (LFD) for extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) remains unclear. We evaluated the impact of LFD on neurological outcomes based on..

Lee mas
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Is the use of ECPR for OHCA ready for broad implementation?

Abstract The use of Extracorporeal Cardiopulmonary Resuscitation (ECPR) in cases of cardiac arrest is increasing, as addressed in the number of cases in the Extracorporeal Life Support Organization (ELSO) dashboard. Of..

Lee mas
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Trends and institutional patterns of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Korea: a nationwide analysis, 2016–2023

Abstract Background While the clinical effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) has gained increasing attention, its real-world utilization, patient selection, and system-level implementation remain incompletely..

Lee mas
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Optimizing Extracorporeal Cardiopulmonary Resuscitation Delivery for Out-of-Hospital Cardiac Arrest: A Monte Carlo Simulation Study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) can improve outcomes in refractory out-of-hospital cardiac arrest (OHCA), but access is limited by geographic and system constraints. We aimed to compare the potential..

Lee mas
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Venovenous extracorporeal membrane oxygenation with mechanical chest compression for cardiopulmonary resuscitation: A porcine model study

Abstract Objective To evaluate the effectiveness of venovenous (VV) extracorporeal membrane oxygenation (ECMO) using a dual-lumen cannula coupled with continuous mechanical chest compressions (cMCC) for cardiopulmonary resuscitation and compare it..

Lee mas
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CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report

Abstract BackgroundCPR-induced consciousness (CPRIC) is defined as consciousness during CPR, ranging from eye opening to combative behaviour and vocalisation, despite the absence of spontaneous circulation. CPRIC has not previously been..

Lee mas
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Extracorporeal membrane oxygenation (ECMO): A narrative review for the emergency clinician

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) is an established therapy that supports a patient in respiratory or cardiopulmonary failure to recovery, transplant, or durable mechanical support. Prompt referral by the..

Lee mas
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Hypothermic Circulatory Arrest Is Associated with Increased Risk of Postoperative Delirium: A Retrospective Cohort Study

Abstract Objectives: This study aimed to measure the incidence of postoperative delirium (POD) after aortic arch surgery with hypothermic circulatory arrest (HCA), compare it to cardiac surgeries not requiring HCA, and..

Lee mas
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Investigating the dynamics of intracranial pressure and cerebral autoregulation during extracorporeal cardiopulmonary resuscitation using a porcine model

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising intervention for refractory cardiac arrest, with potential benefits in survival and neurological outcomes. However, the impact of ECPR’s rapid,..

Lee mas
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Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality

Abstract Objectives Age is the main determinant for mortality in patients requiring postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), but strategies to reverse this trend are unknown. This study investigates PC-ECMO outcomes..

Lee mas
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Arterial CO2 Targets in Veno-Arterial Extracorporeal Membrane Oxygenation After Cardiac Arrest

Abstract After cardiac arrest, restoration of circulation is the first step toward survivorship. Extracorporeal CPR (ECPR), the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to restore circulation, is increasingly being..

Lee mas
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A Dutch nationwide pediatric cardiac arrest registry with long-term follow-up – towards an international prognostication guideline

Abstract Aims Pediatric cardiac arrest is associated with high mortality and significant morbidity among survivors. International guidelines for prognostication remain limited due to small heterogeneous patient populations, variable post-return of..

Lee mas
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Consciousness in deep hypothermic circulatory arrest: a feasibility study

Abstract Background Studies have not explored consciousness during deep hypothermic circulatory arrest (DHCA). However, as studies in cardiac arrest have identified a spectrum of consciousness, we sought to establish the..

Lee mas
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Association Between Rewarming Rate and Survival and Neurologic Outcome of Accidental Hypothermia

Abstract Objectives:  Accidental hypothermia has high mortality. Rewarming is the initial primary management strategy. However, detailed evidence on rewarming management is limited, that is, rewarming rate is unclear, particularly with..

Lee mas
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Trends in cardiac arrest care and mortality in United States emergency departments over eight years

Abstract Introduction Cardiac arrest in the emergency department (ED) is a rare event. Prior studies have used dedicated cardiac arrest registries, but few have leveraged “big data” from electronic healthcare..

Lee mas
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Risk assessment of temporary pacing for cardiac arrest after cardiopulmonary bypass-assisted cardiovascular surgery: A case-control study

Abstract Objective Cardiac arrest happens in 0.7%-5.2% patients after cardiovascular surgery, and cases with asystole or severe bradycardia need timely temporary pacing. However, routine temporary pacing wire insertion in cardiopulmonary..

Lee mas
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Mechanical circulatory support in cardiogenic shock: translating trial evidence into real-world practice

Abstract While iterative developments have improved outcomes of patients with myocardial infarction, mortality in patients with acute myocardial infarction cardiogenic shock (AMI-CS) remains stubbornly high. Several promising treatments have ultimately..

Lee mas
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High-risk pulmonary embolism: the significance and perspectives of pulmonary reperfusion

Abstract Rapid hemodynamic stabilization and restoration of pulmonary perfusion are the cornerstones of treatment for high-risk pulmonary embolism (PE). While all current guidelines recommend systemic thrombolysis (SYS) as the first-line..

Lee mas
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Impact of routine extracorporeal cardiopulmonary resuscitation service on the availability of donor organs

Abstract Background In refractory cardiac arrest, extracorporeal cardiopulmonary resuscitation may increase the survival chance. However, in cases of unsuccessful treatment, extracorporeal cardiopulmonary resuscitation may additionally provide an important source of organ donors...

Lee mas
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Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center

Abstract Background: Extracorporeal cardiopulmonary resuscitation (eCPR) is a method for initiation of cardiopulmonary bypass during resuscitation of a patient with refractory cardiac arrest to support end-organ perfusion. This retrospective study evaluates..

Lee mas