Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review.

Détails

ID Serval
serval:BIB_AA9F9BB4241D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review.
Périodique
Artificial organs
Auteur⸱e⸱s
Podsiadło P., Darocha T., Svendsen Ø.S., Kosiński S., Silfvast T., Blancher M., Sawamoto K., Pasquier M.
ISSN
1525-1594 (Electronic)
ISSN-L
0160-564X
Statut éditorial
Publié
Date de publication
03/2021
Peer-reviewed
Oui
Volume
45
Numéro
3
Pages
222-229
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Prolonged cardiac arrest (CA) may lead to neurologic deficit in survivors. Good outcome is especially rare when CA was unwitnessed. However, accidental hypothermia is a very specific cause of CA. Our goal was to describe the outcomes of patients who suffered from unwitnessed hypothermic cardiac arrest (UHCA) supported with Extracorporeal Life Support (ECLS). We included consecutive patients' cohorts identified by systematic literature review concerning patients suffering from UHCA and rewarmed with ECLS. Patients were divided into four subgroups regarding the mechanism of cooling, namely: air exposure; immersion; submersion; and avalanche. A statistical analysis was performed in order to identify the clinical parameters associated with good outcome (survival and absence of neurologic impairment). A total of 221 patients were included into the study. The overall survival rate was 27%. Most of the survivors (83%), had no neurologic deficit. Asystole was the presenting CA rhythm in 48% survivors, of which 79% survived with good neurologic outcome. Variables associated with survival included the following: female gender (P < .001); low core temperature (P = .005); non-asphyxia-related mechanism of cooling (P < .001); pulseless electrical activity as an initial rhythm (P < .001); high blood pH (P < .001); low lactate levels (P = .003); low serum potassium concentration (P < .001); and short resuscitation duration (P = .004). Severely hypothermic patients with unwitnessed CA may survive with good neurologic outcome, including those presenting as asystole. The initial blood pH, potassium, and lactate concentration may help predict outcome in hypothermic CA.
Mots-clé
Accidental hypothermia, Cardiac arrest, ECPR, Resuscitation, Triage, accidental hypothermia, cardiac arrest, extracorporeal cardiopulmonary resuscitation, triage
Pubmed
Web of science
Création de la notice
19/09/2020 13:28
Dernière modification de la notice
16/03/2021 7:25
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