21 Oct CHEST 2014: ECMO CPR May Improve Patient Recovery
MedicalResearch.com Interview with:
Graham Peigh, BA
Thomas Jefferson University
Medical Research: What are the main findings of the study?
Response: The main findings of our study show that extracorporeal cardiopulmonary resuscitation (E-CPR) can provide recovery when a patient is unresponsive to conventional CPR. In our sample of 24 patients, 13 survived ECMO, and 7 were successfully discharged from the hospital. Major meta analytic studies have shown that in-hospital CPR yields a discharge rate of under 20%, and our study presents results which demonstrate that E-CPR provides a method by which those survival figures can be increased. Importantly, our study also showed that vital organ function among ECMO survivors was maintained. All13 patients had improved or unchanged kidney and liver function, and 12/13 had improved or unchanged metabolic function. After using standard hypothermia protocols, all seven hospital survivors had full neurological recovery. This study differs from the majority of other studies on E-CPR because our institution does not have a dedicated E-CPR/Code team available to perform E-CPR 24/7. We believe that our results are thus generalizable to other academic institutions, which, like ours, have the capability to perform E-CPR, but are only able to do so during on-hours when physicians, perfusionists, and ECMO materials are available.
Medical Research: What was most surprising about the results?
Response: We were pleasantly surprised with the impressive solid organ recovery among ECMO survivors, and grossly intact neurological recovery among all hospital survivors. Even among the patients who died of an anoxic brain injury, two were able to donate organs for transplant.
Medical Research: What should clinicians and patients take away from your report?
Response: E-CPR provides a good alternative for patients who require resuscitation and are unresponsive to conventional CPR. E-CPR can improve the prognosis for these patients who would otherwise face undesirable outcomes.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: The majority of E-CPR associated deaths in our sample were neurological in nature. Further research to determine how to protect a patient’s brain during E-CPR could improve prognoses. Continuing to look at survival trends with a larger sample size will also be beneficial.