RESUMO
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) use in patients with cardiac arrest is increasing. Utilization remains variable between centers using ECMO as a rescue therapy or early protocolized extracorporeal cardiopulmonary resuscitation. METHODS: Single-center, retrospective evaluation of cardiac arrest with cardiopulmonary resuscitation and rescue ECMO support from 2011 through 2019. Study objectives included survival, non-neurologic, and neurologic outcomes; validation of the SAVE and modified SAVE (mSAVE) scores for survival and favorable neurologic outcome; and predictive factor identification in cardiac arrest with ECMO rescue therapy. RESULTS: Eighty-nine patients were included. In-hospital survival was 38.2% and median CPC score was 2. Survivors had lower BMI (27.9â±â4.2âkg/m2 vs. 32.3â±â7.5âkg/m2, Pâ=â0.003), less obesity (BMIâ≥â30âkg/m2) (26.5% vs. 49.1%, Pâ=â0.035), shorter CPR duration (35.5â±â31.7âm vs. 58.0â±â49.5âm, Pâ=â0.019), more tracheostomy (38.2% vs. 7.3%, Pâ<â0.001), and less renal replacement therapy (RRT) (17.6% vs. 38.2%, Pâ=â0.031). Patients with a favorable neurologic outcome had lower body weight (86.2â±â17.9âkg vs. 98.1â±â19.4âkg, Pâ=â0.010), lower BMI (28.1â±â4.5âkg/m2 vs. 33.9â±â7.9âkg/m2, Pâ<â0.001), and less obesity (29.7% vs. 56.3%, Pâ=â0.026). mSAVE score predicted in-hospital survival (OR 1.11; 95%CI 1.03-1.19; Pâ=â0.004) and favorable neurologic outcome (OR 1.11; 1.03-1.20; Pâ=â0.009). Multivariate analysis for in-hospital survival included mSAVE, BMI, CPR-time, tracheostomy, and RRT (c-statistic: 0.864). Favorable neurologic outcome included mSAVE and BMI (c-statistic: 0.805). CONCLUSIONS: mSAVE, BMI, RRT, and tracheostomy are predictors of in-hospital survival and mSAVE and BMI are predictors of favorable neurologic outcome in cardiac arrest with ECMO rescue therapy.