PDF(Pubmed)
Abstract：
UNASSIGNED: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants.
UNASSIGNED: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021.
UNASSIGNED: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant.
UNASSIGNED: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.
UNASSIGNED: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021.
UNASSIGNED: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant.
UNASSIGNED: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.
摘要：
■当复苏失败时，体外心肺复苏（E-CPR）起着不可或缺的作用；但是，婴儿的体外生命支持（ECLS）与成人不同。这项研究的目的是评估婴儿E-CPR的结果。
■进行了单中心回顾性研究，分析2010年至2021年间因院内心脏骤停而接受E-CPR的51例连续患者（年龄<1岁）。
■年龄和体重中位数为51天（四分位距[IQR]，17-111天）和3.4公斤（IQR，2.9-5.1kg),分别。45例患者(88.2%)心源性猝死,48例(94.1%)有先天性心脏异常。开始ECLS前的中位常规心肺复苏（C-CPR）时间为77分钟（IQR，61-103分钟)，ECLS的持续时间为7天(IQR，3-12天）。有36例住院死亡（70.6%），另一个病人在心脏移植后存活下来.在多变量分析中，单心室生理学(比值比[OR]，5.05；p=0.048），胸骨开放状态(或，8.69；p=0.013），和C-CPR时间(或，每10分钟1.47；p=0.021）是住院死亡率的重要预测因子。在接收器工作特性曲线中，C-CPR时间的最佳截止时间为70.5分钟.早期E-CPR（C-CPR时间<70.5分钟）的亚组显示出较低的住院死亡率趋势（54.5％vs.82.8%,p=0.060),尽管没有统计学意义。
■如果婴儿复苏失败，电子心肺复苏术可能是一种拯救生命的选择。提高C-CPR质量和缩短ECLS开始前的时间至关重要。
■进行了单中心回顾性研究，分析2010年至2021年间因院内心脏骤停而接受E-CPR的51例连续患者（年龄<1岁）。
■年龄和体重中位数为51天（四分位距[IQR]，17-111天）和3.4公斤（IQR，2.9-5.1kg),分别。45例患者(88.2%)心源性猝死,48例(94.1%)有先天性心脏异常。开始ECLS前的中位常规心肺复苏（C-CPR）时间为77分钟（IQR，61-103分钟)，ECLS的持续时间为7天(IQR，3-12天）。有36例住院死亡（70.6%），另一个病人在心脏移植后存活下来.在多变量分析中，单心室生理学(比值比[OR]，5.05；p=0.048），胸骨开放状态(或，8.69；p=0.013），和C-CPR时间(或，每10分钟1.47；p=0.021）是住院死亡率的重要预测因子。在接收器工作特性曲线中，C-CPR时间的最佳截止时间为70.5分钟.早期E-CPR（C-CPR时间<70.5分钟）的亚组显示出较低的住院死亡率趋势（54.5％vs.82.8%,p=0.060),尽管没有统计学意义。
■如果婴儿复苏失败，电子心肺复苏术可能是一种拯救生命的选择。提高C-CPR质量和缩短ECLS开始前的时间至关重要。
