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Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest.
Suverein, Martje M; Delnoij, Thijs S R; Lorusso, Roberto; Brandon Bravo Bruinsma, George J; Otterspoor, Luuk; Elzo Kraemer, Carlos V; Vlaar, Alexander P J; van der Heijden, Joris J; Scholten, Erik; den Uil, Corstiaan; Jansen, Tim; van den Bogaard, Bas; Kuijpers, Marijn; Lam, Ka Yan; Montero Cabezas, José M; Driessen, Antoine H G; Rittersma, Saskia Z H; Heijnen, Bram G; Dos Reis Miranda, Dinis; Bleeker, Gabe; de Metz, Jesse; Hermanides, Renicus S; Lopez Matta, Jorge; Eberl, Susanne; Donker, Dirk W; van Thiel, Robert J; Akin, Sakir; van Meer, Oene; Henriques, José; Bokhoven, Karen C; Mandigers, Loes; Bunge, Jeroen J H; Bol, Martine E; Winkens, Bjorn; Essers, Brigitte; Weerwind, Patrick W; Maessen, Jos G; van de Poll, Marcel C G.
Affiliation
  • Suverein MM; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Delnoij TSR; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Lorusso R; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Brandon Bravo Bruinsma GJ; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Otterspoor L; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Elzo Kraemer CV; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Vlaar APJ; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • van der Heijden JJ; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Scholten E; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • den Uil C; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Jansen T; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • van den Bogaard B; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Kuijpers M; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Lam KY; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Montero Cabezas JM; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Driessen AHG; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Rittersma SZH; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Heijnen BG; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Dos Reis Miranda D; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Bleeker G; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • de Metz J; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Hermanides RS; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Lopez Matta J; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Eberl S; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Donker DW; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • van Thiel RJ; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Akin S; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • van Meer O; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Henriques J; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Bokhoven KC; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Mandigers L; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Bunge JJH; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Bol ME; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Winkens B; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Essers B; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Weerwind PW; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • Maessen JG; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
  • van de Poll MCG; From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Publi
N Engl J Med ; 388(4): 299-309, 2023 01 26.
Article in En | MEDLINE | ID: mdl-36720132
ABSTRACT

BACKGROUND:

Extracorporeal cardiopulmonary resuscitation (CPR) restores perfusion and oxygenation in a patient who does not have spontaneous circulation. The evidence with regard to the effect of extracorporeal CPR on survival with a favorable neurologic outcome in refractory out-of-hospital cardiac arrest is inconclusive.

METHODS:

In this multicenter, randomized, controlled trial conducted in the Netherlands, we assigned patients with an out-of-hospital cardiac arrest to receive extracorporeal CPR or conventional CPR (standard advanced cardiac life support). Eligible patients were between 18 and 70 years of age, had received bystander CPR, had an initial ventricular arrhythmia, and did not have a return of spontaneous circulation within 15 minutes after CPR had been initiated. The primary outcome was survival with a favorable neurologic outcome, defined as a Cerebral Performance Category score of 1 or 2 (range, 1 to 5, with higher scores indicating more severe disability) at 30 days. Analyses were performed on an intention-to-treat basis.

RESULTS:

Of the 160 patients who underwent randomization, 70 were assigned to receive extracorporeal CPR and 64 to receive conventional CPR; 26 patients who did not meet the inclusion criteria at hospital admission were excluded. At 30 days, 14 patients (20%) in the extracorporeal-CPR group were alive with a favorable neurologic outcome, as compared with 10 patients (16%) in the conventional-CPR group (odds ratio, 1.4; 95% confidence interval, 0.5 to 3.5; P = 0.52). The number of serious adverse events per patient was similar in the two groups.

CONCLUSIONS:

In patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR and conventional CPR had similar effects on survival with a favorable neurologic outcome. (Funded by the Netherlands Organization for Health Research and Development and Maquet Cardiopulmonary [Getinge]; INCEPTION ClinicalTrials.gov number, NCT03101787.).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Out-of-Hospital Cardiac Arrest Type of study: Clinical_trials Limits: Humans Country/Region as subject: Europa Language: En Journal: N Engl J Med Year: 2023 Type: Article
Fulltext
Print
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PubMed Links
Search on Google

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Out-of-Hospital Cardiac Arrest Type of study: Clinical_trials Limits: Humans Country/Region as subject: Europa Language: En Journal: N Engl J Med Year: 2023 Type: Article