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CHEST 2014: Adding ECMO to CPR

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The Particulars: Research indicates that less than 50% of sudden cardiac death patients survive with conventional cardiopulmonary resuscitation (CPR), and less than 20% survive to hospital discharge. Other studies have found a 20% improvement in survival with extracorporeal membrane oxygenation (ECMO) at the time of CPR (E-CPR) when compared with CPR alone.

Data Breakdown: To address the feasibility and viability of E-CPR outside of centers that have dedicated E-CPR and code teams, researchers analyzed 100 adult ECMO procedures. Among 24 patients who underwent E-CPR, 11 were not resuscitated. Six patients survived E-CPR but died before hospital discharge. All 13 who survived E-CPR had unchanged liver and kidney function, and 12 had infrequent changes in metabolic function. All seven who were discharged from the hospital had intact neurological status.

Take Home Pearls: More than half of patients appear to survive sudden cardiac death when treated with E-CPR. Among those who survive E-CPR, more than half appear to recover neurologically before they leave the hospital.

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