Acute cardiac care & resuscitation
Acute lung injury and recovery in patients with refractory VT/VF cardiac arrest treated with prolonged CPR and veno-arterial extracorporeal membrane oxygenation
Authors' conclusion
Lung injury is common among patients with refractory VT/VF OHCA requiring V-A ECMO, but imaging severity is not associated with survival. Reductions in lung compliance accompany post-arrest lung injury while compliance recovery is associated with survival.
Study context
- Population
- Patients with refractory VT/VF OHCA supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) facilitated resuscitation
- Participants
- 138 patients
- Exposure
- Survivors vs brain death vs other causes of death
- Survivorsn = 48
- Brain deathn = 31
- Other causes of deathn = 59
- Outcome
- Lung injury patterns
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Lung injury in ≥1 lung area on chest computed tomography (CT), predominantly dependent posterior areas
- 124/135 (91.8%)
- Compliance improved throughout hospitalization
- P = 0.03
- Compliance recovered faster in survivors vs those who died
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Survivors | Brain death | Other causes of death | |
|---|---|---|---|---|
| Survival status | 34.8% | Not reported in the abstract | Not reported in the abstract | Brain death, Other causes of death: not reported in the abstract |
Extubation and tracheostomy
- Successful extubation
- 39/138 (28%)
- Median time to extubation in survivors (days)
- 8.0 (6.0, 11.0)
- Tracheostomy in survivors
- 15/48 (31.3%)
Ventilation on VA-ECMO
- VA-ECMO allowed lung-protective ventilation while maintaining normalized PaO2 and PaCO2
VA-ECMO plus IABP or Impella vs VA-ECMO alone
- Lower pulmonary compliance and more affected CT areas with VA-ECMO plus IABP or Impella
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Acute lung injury and recovery in patients with refractory VT/VF cardiac arrest treated with prolonged CPR and veno-arterial extracorporeal membrane oxygenation. Resuscitation. Published 25 November 2022. doi:10.
Summarised from the published abstract; every number is checked against it