Out-Of-Hospital Cardiac Arrest
Conditions
Keywords
Cardiac arrest, ECMO, ECMO-CPR
Brief summary
The purpose of this study is to assess the efficacy of institutionalized care program of patients with out-of-hospital cardiac arrest.
Detailed description
Patients with out-of-hospital cardiac arrest included in the program will be treated with extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (CPR) with additional invasive procedures including coronary/pulmonary angiography and intervention. This type of treatment was not provided in institutionalized fashion in Wroclaw, Poland. Implementation of this program should improve survival in out-of-hospital cardiac arrest patients, which currently is less than 10%.
Interventions
OTHERECMO assisted CPR in out-of-hospital cardiac arrest
Patients included in the registry will be transferred during LUCAS assisted CPR by the Wroclaw Emergency Medical Services to the Emergency Department of the Wroclaw University Hospital where blood gasses will be assessed. If two or more of the following: end-tidal carbon dioxide (CO2) \> 10 mm Hg, arterial partial pressure of oxygen (PaO2) \>50 mm Hg or oxygen saturation \>85%, and lactic acid \<18 mmol/L will be fulfilled patient will be further transferred to the Cardiac Catheterization Laboratory for V-A ECMO implantation followed by coronary/pulmonary artery angiography and intervention.
Sponsors
Wroclaw Emergency Medical Services
Wroclaw Medical University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age \< 60 years * witnessed sudden cardiac arrest with immediate CPR * supposed cardiac cause of the event * ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) at first medical contact with 3 unsuccessful defibrillations (no ROSC) * CPR conducted with Lund University Cardiopulmonary Assist System (LUCAS™) * Estimated transfer time from the scene to the Emergency Department \< 30 minutes. * End tidal carbon dioxide (ETCO2) \> 10 mmHg
Exclusion criteria
* Total presumed time from 112 call to ECMO implantation longer than 60 minutes * Age \< 18 years old or \> 60 years old; * Non-shockable initial rhythm * Unavailability of the automated CPR device * Unavailability of the catheterisation laboratory * Severe concomitant illness with decreased life expectancy * Severe body injury * Severe active bleeding * Drowning * Terminal cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mortality | 1 month | all cause mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| degree of disability | 3 and 6 months after index event | Modified Rankin Scale of 3 or lower |
Countries
Poland
Contacts
Primary ContactWiktor Kuliczkowski, MD
Outcome results
None listed