Affiliation:
1. Academician I.P. Pavlov First St. Petersburg State Medical University
Abstract
Relevance. The timely use of extracorporeal membrane oxygenation within resuscitation measures for patients with refractory circulatory arrest is becoming a routine rescue practice in the world, making it possible to increase the efficiency of resuscitation measures up to 30 %; however, this technology is not widespread in Russia, despite the fact that without extracorporeal mechanical support, the effectiveness of cardiopulmonary resuscitation is no more than 9 %.Objective. Analysis of the experience of using transport venoarterial extracorporeal membrane oxygenation (ECMO) within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Methods. Analysis of the experience of using transport ECMO within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Results and Discussion. Of the 16 cases of extracorporeal cardiopulmonary resuscitation, effective circulation was restored in 37.5 % (6 out of 16) of cases. In these cases, the duration of extended cardiopulmonary resuscitation outside the medical organization was significantly lower, (50.8 ± 4.2) minutes versus (65.6 ± 4.6) minutes. In the group of patients with ineffective extended cardiopulmonary resuscitation, there was a significant increase in troponin (1820 ± 164) versus (473 ± 180) ng/l and D-dimer (17 566 ± 429) versus (13 122 ± 628) µg/l (FEU).Conclusion. Transport ECMO technology, which is used for extracorporeal cardiopulmonary resuscitation in patients with out-of-hospital refractory circulatory arrest, allows the use of a wide range of diagnostic and therapeutic procedures, including percutaneous coronary interventions. The analysis revealed the need to reduce the duration of resuscitation by ambulance teams on the spot in favor of extended CPR in motion using an electromechanical device for chest compressions.
Subject
Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Clinical Psychology,Emergency Medicine,Emergency Medical Services
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