Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center
<b>Background:</b> 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 which prognostic markers are see...
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MDPI AG
2025-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/10/1275 |
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| author | Kamran Namjouyan Aastha Mittal Evan Gajkowski Amanda Young Sudheer Penupolu Brendan Carry |
| author_facet | Kamran Namjouyan Aastha Mittal Evan Gajkowski Amanda Young Sudheer Penupolu Brendan Carry |
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| description | <b>Background:</b> 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 which prognostic markers are seen in patients with poor outcomes who underwent eCPR in our rural tertiary care center. <b>Study Design/Methods:</b> All patients who underwent eCPR at our center from May 2013 to January 2023 were analyzed in a retrospective manner. We then compared outcomes in patients who survived to discharge (survivors) versus those who did not survive to discharge (non-survivors). Demographic factors, body mass index, peak serum lactate in 24 h, initial rhythm, lowest mean arterial pressure within the first six hours, a requirement of renal replacement therapy, and the number of blood transfusions required during the hospitalization were analyzed. <b>Results:</b> 37 patients (24 males and 13 females) with a median age of 58 years (IQR: 48–65) were included. The overall mortality rate was 75.7%, and all survivors had good neurological outcomes, which were defined as Cerebral Performance Category (CPC) scores of 1 or 2. The most significant factors seen in non-survivors were obesity as measured by BMI more than 30 (odds ratio = 7.33; 95% CI 1.40–38.33; <i>p</i> = 0.02), and lowest MAP <65 within the first 6 h despite being on extracorporeal membrane oxygenation (0% vs. 74.1%; <i>p</i> = <0.01). <b>Conclusions:</b> This retrospective study demonstrates that initial presentations of patients who underwent eCPR with obesity and MAPS < 65 within the first 6 h despite ECMO support were seen in patients with higher mortality. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-212a47668ee84f4eac0c6af14b18c0ab2025-08-20T01:56:16ZengMDPI AGDiagnostics2075-44182025-05-011510127510.3390/diagnostics15101275Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care CenterKamran Namjouyan0Aastha Mittal1Evan Gajkowski2Amanda Young3Sudheer Penupolu4Brendan Carry5Medicine Institute, Geisinger Medical Center, Danville, PA 17821, USACritical Care Institute, Geisinger Medical Center, Danville, PA 17821, USAHeart Institute, Geisinger Medical Center, Danville, PA 17821, USABiostatistics Institute, Geisinger Medical Center, Danville, PA 17821, USACritical Care Institute, Geisinger Medical Center, Danville, PA 17821, USAHeart Institute, Geisinger Medical Center, Danville, PA 17821, USA<b>Background:</b> 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 which prognostic markers are seen in patients with poor outcomes who underwent eCPR in our rural tertiary care center. <b>Study Design/Methods:</b> All patients who underwent eCPR at our center from May 2013 to January 2023 were analyzed in a retrospective manner. We then compared outcomes in patients who survived to discharge (survivors) versus those who did not survive to discharge (non-survivors). Demographic factors, body mass index, peak serum lactate in 24 h, initial rhythm, lowest mean arterial pressure within the first six hours, a requirement of renal replacement therapy, and the number of blood transfusions required during the hospitalization were analyzed. <b>Results:</b> 37 patients (24 males and 13 females) with a median age of 58 years (IQR: 48–65) were included. The overall mortality rate was 75.7%, and all survivors had good neurological outcomes, which were defined as Cerebral Performance Category (CPC) scores of 1 or 2. The most significant factors seen in non-survivors were obesity as measured by BMI more than 30 (odds ratio = 7.33; 95% CI 1.40–38.33; <i>p</i> = 0.02), and lowest MAP <65 within the first 6 h despite being on extracorporeal membrane oxygenation (0% vs. 74.1%; <i>p</i> = <0.01). <b>Conclusions:</b> This retrospective study demonstrates that initial presentations of patients who underwent eCPR with obesity and MAPS < 65 within the first 6 h despite ECMO support were seen in patients with higher mortality.https://www.mdpi.com/2075-4418/15/10/1275refractory cardiac arrestextracorporeal cardiopulmonary resuscitationprognostic markers |
| spellingShingle | Kamran Namjouyan Aastha Mittal Evan Gajkowski Amanda Young Sudheer Penupolu Brendan Carry Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center Diagnostics refractory cardiac arrest extracorporeal cardiopulmonary resuscitation prognostic markers |
| title | Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center |
| title_full | Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center |
| title_fullStr | Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center |
| title_full_unstemmed | Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center |
| title_short | Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center |
| title_sort | outcomes and prognostic markers in extracorporeal cardiopulmonary resuscitation 10 year experience from a rural tertiary care center |
| topic | refractory cardiac arrest extracorporeal cardiopulmonary resuscitation prognostic markers |
| url | https://www.mdpi.com/2075-4418/15/10/1275 |
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