Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study

Wulfran Bougouin; Florence Dumas; Lionel Lamhaut; Eloi Marijon; Pierre Carli; Alain Combes; Romain Pirracchio; Nadia Aissaoui; Nicole Karam; Nicolas Deye; Georgios Sideris; Frankie Beganton; Daniel Jost; Alain Cariou; Xavier Jouven; F. Adnet; J. M. Agostinucci; N. Aissaoui-Balanant; V. Algalarrondo; F. Alla; C. Alonso; W. Amara; D. Annane; C. Antoine; P. Aubry; E. Azoulay; F. Beganton; D. Benhamou; C. Billon; W. Bougouin; J. Boutet; C. Bruel; P. Bruneval; A. Cariou; P. Carli; E. Casalino; C. Cerf; A. Chaib; B. Cholley; Y. Cohen; A. Combes; M. Crahes; D. Da Silva; V. Das; A. Demoule; I. Denjoy; N. Deye; G. Dhonneur; J. L. Diehl; S. Dinanian; L. Domanski; D. Dreyfuss; D. Duboc; J. L. Dubois-Rande; F. Dumas; J. P. Empana; F. Extramiana; M. Fartoukh; F. Fieux; M. Gabbas; E. Gandjbakhch; G. Geri; B. Guidet; F. Halimi; P. Henry; F. Hidden Lucet; P. Jabre; L. Jacob; L. Joseph; D. Jost; N. Karam; H. Kassim; J. Lacotte; K. Lahlou-Laforet; L. Lamhaut; A. Lanceleur; O. Langeron; T. Lavergne; E. Lecarpentier; A. Leenhardt; N. Lellouche; V. Lemiale; F. Lemoine; F. Linval; T. Loeb; B. Ludes; C. E. Luyt; A. Maltret; N. Mansencal; N. Mansouri; E. Marijon; J. Marty; E. Maury; V. Maxime; B. Megarbane; A. Mekontso-Dessap; H. Mentec; J. P. Mira; X. Monnet; K. Narayanan; N. Ngoyi; M. C. Perier; O. Piot; R. Pirracchio; P. Plaisance; I. Plu; M. Raux; F. Revaux; J. D. Ricard; C. Richard; B. Riou; F. Roussin; F. Santoli; F. Schortgen; A. Sharifzadehgan; G. Sideris; C. Spaulding; J. L. Teboul; J. F. Timsit; J. P. Tourtier; P. Tuppin; C. Ursat; O. Varenne; A. Vieillard-Baron; S. Voicu; K. Wahbi; V. Waldmann

doi:10.1093/eurheartj/ehz753

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study

Wulfran Bougouin, Florence Dumas, Lionel Lamhaut, Eloi Marijon, Pierre Carli, Alain Combes, Romain Pirracchio, Nadia Aissaoui, Nicole Karam, Nicolas Deye, Georgios Sideris, Frankie Beganton, Daniel Jost, Alain Cariou, Xavier Jouven, F. Adnet, J. M. Agostinucci, N. Aissaoui-Balanant, V. Algalarrondo, F. AllaC. Alonso, W. Amara, D. Annane, C. Antoine, P. Aubry, E. Azoulay, F. Beganton, D. Benhamou, C. Billon, W. Bougouin, J. Boutet, C. Bruel, P. Bruneval, A. Cariou, P. Carli, E. Casalino, C. Cerf, A. Chaib, B. Cholley, Y. Cohen, A. Combes, M. Crahes, D. Da Silva, V. Das, A. Demoule, I. Denjoy, N. Deye, G. Dhonneur, J. L. Diehl, S. Dinanian, L. Domanski, D. Dreyfuss, D. Duboc, J. L. Dubois-Rande, F. Dumas, J. P. Empana, F. Extramiana, M. Fartoukh, F. Fieux, M. Gabbas, E. Gandjbakhch, G. Geri, B. Guidet, F. Halimi, P. Henry, F. Hidden Lucet, P. Jabre, L. Jacob, L. Joseph, D. Jost, N. Karam, H. Kassim, J. Lacotte, K. Lahlou-Laforet, L. Lamhaut, A. Lanceleur, O. Langeron, T. Lavergne, E. Lecarpentier, A. Leenhardt, N. Lellouche, V. Lemiale, F. Lemoine, F. Linval, T. Loeb, B. Ludes, C. E. Luyt, A. Maltret, N. Mansencal, N. Mansouri, E. Marijon, J. Marty, E. Maury, V. Maxime, B. Megarbane, A. Mekontso-Dessap, H. Mentec, J. P. Mira, X. Monnet, K. Narayanan, N. Ngoyi, M. C. Perier, O. Piot, R. Pirracchio, P. Plaisance, I. Plu, M. Raux, F. Revaux, J. D. Ricard, C. Richard, B. Riou, F. Roussin, F. Santoli, F. Schortgen, A. Sharifzadehgan, G. Sideris, C. Spaulding, J. L. Teboul, J. F. Timsit, J. P. Tourtier, P. Tuppin, C. Ursat, O. Varenne, A. Vieillard-Baron, S. Voicu, K. Wahbi, V. Waldmann

Department of Medicine

Research output: Contribution to journal › Article › peer-review

185 Scopus citations

Abstract

Aims: Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results: We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8-2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5-1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5-10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1-4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5-5.9; P = 0.002). Conclusions: In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.

Original language	English (US)
Pages (from-to)	1961-1971
Number of pages	11
Journal	European Heart Journal
Volume	41
Issue number	21
DOIs	https://doi.org/10.1093/eurheartj/ehz753
State	Published - Jun 1 2020

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

Access to Document

10.1093/eurheartj/ehz753

Cite this

Bougouin, W., Dumas, F., Lamhaut, L., Marijon, E., Carli, P., Combes, A., Pirracchio, R., Aissaoui, N., Karam, N., Deye, N., Sideris, G., Beganton, F., Jost, D., Cariou, A., Jouven, X., Adnet, F., Agostinucci, J. M., Aissaoui-Balanant, N., Algalarrondo, V., ... Waldmann, V. (2020). Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study. European Heart Journal, 41(21), 1961-1971. https://doi.org/10.1093/eurheartj/ehz753

@article{5423973710124d7f8d7c6d5f37b0e2b6,

title = "Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study",

abstract = "Aims: Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results: We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8-2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5-1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5-10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1-4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5-5.9; P = 0.002). Conclusions: In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.",

author = "Wulfran Bougouin and Florence Dumas and Lionel Lamhaut and Eloi Marijon and Pierre Carli and Alain Combes and Romain Pirracchio and Nadia Aissaoui and Nicole Karam and Nicolas Deye and Georgios Sideris and Frankie Beganton and Daniel Jost and Alain Cariou and Xavier Jouven and F. Adnet and Agostinucci, {J. M.} and N. Aissaoui-Balanant and V. Algalarrondo and F. Alla and C. Alonso and W. Amara and D. Annane and C. Antoine and P. Aubry and E. Azoulay and F. Beganton and D. Benhamou and C. Billon and W. Bougouin and J. Boutet and C. Bruel and P. Bruneval and A. Cariou and P. Carli and E. Casalino and C. Cerf and A. Chaib and B. Cholley and Y. Cohen and A. Combes and M. Crahes and {Da Silva}, D. and V. Das and A. Demoule and I. Denjoy and N. Deye and G. Dhonneur and Diehl, {J. L.} and S. Dinanian and L. Domanski and D. Dreyfuss and D. Duboc and Dubois-Rande, {J. L.} and F. Dumas and Empana, {J. P.} and F. Extramiana and M. Fartoukh and F. Fieux and M. Gabbas and E. Gandjbakhch and G. Geri and B. Guidet and F. Halimi and P. Henry and {Hidden Lucet}, F. and P. Jabre and L. Jacob and L. Joseph and D. Jost and N. Karam and H. Kassim and J. Lacotte and K. Lahlou-Laforet and L. Lamhaut and A. Lanceleur and O. Langeron and T. Lavergne and E. Lecarpentier and A. Leenhardt and N. Lellouche and V. Lemiale and F. Lemoine and F. Linval and T. Loeb and B. Ludes and Luyt, {C. E.} and A. Maltret and N. Mansencal and N. Mansouri and E. Marijon and J. Marty and E. Maury and V. Maxime and B. Megarbane and A. Mekontso-Dessap and H. Mentec and Mira, {J. P.} and X. Monnet and K. Narayanan and N. Ngoyi and Perier, {M. C.} and O. Piot and R. Pirracchio and P. Plaisance and I. Plu and M. Raux and F. Revaux and Ricard, {J. D.} and C. Richard and B. Riou and F. Roussin and F. Santoli and F. Schortgen and A. Sharifzadehgan and G. Sideris and C. Spaulding and Teboul, {J. L.} and Timsit, {J. F.} and Tourtier, {J. P.} and P. Tuppin and C. Ursat and O. Varenne and A. Vieillard-Baron and S. Voicu and K. Wahbi and V. Waldmann",

year = "2020",

month = jun,

day = "1",

doi = "10.1093/eurheartj/ehz753",

language = "English (US)",

volume = "41",

pages = "1961--1971",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "21",

}

Bougouin, W, Dumas, F, Lamhaut, L, Marijon, E, Carli, P, Combes, A, Pirracchio, R, Aissaoui, N, Karam, N, Deye, N, Sideris, G, Beganton, F, Jost, D, Cariou, A, Jouven, X, Adnet, F, Agostinucci, JM, Aissaoui-Balanant, N, Algalarrondo, V, Alla, F, Alonso, C, Amara, W, Annane, D, Antoine, C, Aubry, P, Azoulay, E, Beganton, F, Benhamou, D, Billon, C, Bougouin, W, Boutet, J, Bruel, C, Bruneval, P, Cariou, A, Carli, P, Casalino, E, Cerf, C, Chaib, A, Cholley, B, Cohen, Y, Combes, A, Crahes, M, Da Silva, D, Das, V, Demoule, A, Denjoy, I, Deye, N, Dhonneur, G, Diehl, JL, Dinanian, S, Domanski, L, Dreyfuss, D, Duboc, D, Dubois-Rande, JL, Dumas, F, Empana, JP, Extramiana, F, Fartoukh, M, Fieux, F, Gabbas, M, Gandjbakhch, E, Geri, G, Guidet, B, Halimi, F, Henry, P, Hidden Lucet, F, Jabre, P, Jacob, L, Joseph, L, Jost, D, Karam, N, Kassim, H, Lacotte, J, Lahlou-Laforet, K, Lamhaut, L, Lanceleur, A, Langeron, O, Lavergne, T, Lecarpentier, E, Leenhardt, A, Lellouche, N, Lemiale, V, Lemoine, F, Linval, F, Loeb, T, Ludes, B, Luyt, CE, Maltret, A, Mansencal, N, Mansouri, N, Marijon, E, Marty, J, Maury, E, Maxime, V, Megarbane, B, Mekontso-Dessap, A, Mentec, H, Mira, JP, Monnet, X, Narayanan, K, Ngoyi, N, Perier, MC, Piot, O, Pirracchio, R, Plaisance, P, Plu, I, Raux, M, Revaux, F, Ricard, JD, Richard, C, Riou, B, Roussin, F, Santoli, F, Schortgen, F, Sharifzadehgan, A, Sideris, G, Spaulding, C, Teboul, JL, Timsit, JF, Tourtier, JP, Tuppin, P, Ursat, C, Varenne, O, Vieillard-Baron, A, Voicu, S, Wahbi, K & Waldmann, V 2020, 'Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study', European Heart Journal, vol. 41, no. 21, pp. 1961-1971. https://doi.org/10.1093/eurheartj/ehz753

TY - JOUR

T1 - Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest

T2 - A registry study

AU - Bougouin, Wulfran

AU - Dumas, Florence

AU - Lamhaut, Lionel

AU - Marijon, Eloi

AU - Carli, Pierre

AU - Combes, Alain

AU - Pirracchio, Romain

AU - Aissaoui, Nadia

AU - Karam, Nicole

AU - Deye, Nicolas

AU - Sideris, Georgios

AU - Beganton, Frankie

AU - Jost, Daniel

AU - Cariou, Alain

AU - Jouven, Xavier

AU - Adnet, F.

AU - Agostinucci, J. M.

AU - Aissaoui-Balanant, N.

AU - Algalarrondo, V.

AU - Alla, F.

AU - Alonso, C.

AU - Amara, W.

AU - Annane, D.

AU - Antoine, C.

AU - Aubry, P.

AU - Azoulay, E.

AU - Beganton, F.

AU - Benhamou, D.

AU - Billon, C.

AU - Bougouin, W.

AU - Boutet, J.

AU - Bruel, C.

AU - Bruneval, P.

AU - Cariou, A.

AU - Carli, P.

AU - Casalino, E.

AU - Cerf, C.

AU - Chaib, A.

AU - Cholley, B.

AU - Cohen, Y.

AU - Combes, A.

AU - Crahes, M.

AU - Da Silva, D.

AU - Das, V.

AU - Demoule, A.

AU - Denjoy, I.

AU - Deye, N.

AU - Dhonneur, G.

AU - Diehl, J. L.

AU - Dinanian, S.

AU - Domanski, L.

AU - Dreyfuss, D.

AU - Duboc, D.

AU - Dubois-Rande, J. L.

AU - Dumas, F.

AU - Empana, J. P.

AU - Extramiana, F.

AU - Fartoukh, M.

AU - Fieux, F.

AU - Gabbas, M.

AU - Gandjbakhch, E.

AU - Geri, G.

AU - Guidet, B.

AU - Halimi, F.

AU - Henry, P.

AU - Hidden Lucet, F.

AU - Jabre, P.

AU - Jacob, L.

AU - Joseph, L.

AU - Jost, D.

AU - Karam, N.

AU - Kassim, H.

AU - Lacotte, J.

AU - Lahlou-Laforet, K.

AU - Lamhaut, L.

AU - Lanceleur, A.

AU - Langeron, O.

AU - Lavergne, T.

AU - Lecarpentier, E.

AU - Leenhardt, A.

AU - Lellouche, N.

AU - Lemiale, V.

AU - Lemoine, F.

AU - Linval, F.

AU - Loeb, T.

AU - Ludes, B.

AU - Luyt, C. E.

AU - Maltret, A.

AU - Mansencal, N.

AU - Mansouri, N.

AU - Marijon, E.

AU - Marty, J.

AU - Maury, E.

AU - Maxime, V.

AU - Megarbane, B.

AU - Mekontso-Dessap, A.

AU - Mentec, H.

AU - Mira, J. P.

AU - Monnet, X.

AU - Narayanan, K.

AU - Ngoyi, N.

AU - Perier, M. C.

AU - Piot, O.

AU - Pirracchio, R.

AU - Plaisance, P.

AU - Plu, I.

AU - Raux, M.

AU - Revaux, F.

AU - Ricard, J. D.

AU - Richard, C.

AU - Riou, B.

AU - Roussin, F.

AU - Santoli, F.

AU - Schortgen, F.

AU - Sharifzadehgan, A.

AU - Sideris, G.

AU - Spaulding, C.

AU - Teboul, J. L.

AU - Timsit, J. F.

AU - Tourtier, J. P.

AU - Tuppin, P.

AU - Ursat, C.

AU - Varenne, O.

AU - Vieillard-Baron, A.

AU - Voicu, S.

AU - Wahbi, K.

AU - Waldmann, V.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - Aims: Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results: We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8-2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5-1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5-10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1-4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5-5.9; P = 0.002). Conclusions: In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.

AB - Aims: Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results: We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8-2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5-1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5-10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1-4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5-5.9; P = 0.002). Conclusions: In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.

UR - http://www.scopus.com/inward/record.url?scp=85085712437&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85085712437&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehz753

DO - 10.1093/eurheartj/ehz753

M3 - Article

C2 - 31670793

AN - SCOPUS:85085712437

SN - 0195-668X

VL - 41

SP - 1961

EP - 1971

JO - European Heart Journal

JF - European Heart Journal

IS - 21

ER -

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A registry study

Abstract

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this