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Extracorporeal Cardiopulmonary Resuscitation among Patients with Structurally Normal Hearts.

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eMediNexus    09 November 2017

The objective of a new study published in ASAIO Journal was to evaluate outcomes of extracorporeal cardiopulmonary resuscitation eCPR in patients with structurally normal hearts and to identify risk factors that may contribute to mortality. This retrospective analysis of data included 1 431 patients with a median age of 16 years. The results revealed that the overall survival to hospital discharge was 32 . An independent survival benefit was noted among smaller patients patients with a lower partial pressure of carbon dioxide PaCO2 on cannulation and those with a shorter duration from intubation to eCPR cannulation. In contrast a diagnosis of sepsis was independently associated with a nearly threefold increase in odds of mortality. On the other hand the diagnosis of myocarditis precipitated a more favorable outcome. Furthermore neurologic complications pulmonary hemorrhage disseminated intravascular coagulation CPR pH less than 7.20 and hyperbilirubinemia after eCPR cannulation were independently associated with an increase in odds of mortality. Thus it was inferred that when utilizing eCPR in patients with structurally normal hearts a diagnosis of sepsis is independently associated with mortality whereas a diagnosis of myocarditis is protective. It was stated that neurologic complications and pulmonary hemorrhage while on extracorporeal membrane oxygenation ECMO are independently associated with mortality.

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