Benefit of ECMO in Resuscitation from Refractory V Fib Cardiac Arrest

  The dawn of a new era Although ventricular tachycardia/ventricular fibrillation (v tach/v fib) constitutes only 25-35% of all cardiac arrests, more than 80% of all cardiac arrest survivors with favorable neurological function present with v tach/v fib.1,2 (See Figure 1, p. 12.) Despite that, only one third (approximately 30%) of patients presenting initially with v tach/v fib survive to hospital discharge with good neurological function. Compared to the other presenting rhythms (asystole and pulseless electrical activity) v tach/v fib is associated with the highest survival and stands out as the most important positive predictive factor for neurological intact survival with odd ratios ranging from 15 to > 40.3 As such, v fib remains a very important target to improve overall survival since it represents patients that are viable. Over the last 20 years, a significant body of evidence has emerged highlighting the importance of significant coronary artery disease in patients presenting with v tach/v fib and out-of-hospital cardiac arrest (OHCA).4-8 The accumulated evidence in regard to the presence of coronary artery disease has introduced significant scientific questions about the role of diagnostic and interventional procedures aiming to identify and reverse the potential cause of the arrest. Currently the American Heart Association recommends all patients resuscitated from first presenting shockable rhythms that have ST elevation on the post-resuscitation ECG gain...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news