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Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts

BACKGROUND: Resuscitation after cardiac arrest (CA) in the catheterization laboratory (cath-lab) using mechanical chest compressions (CC) during simultaneous percutaneous coronary intervention (PCI) is a strong recommendation in the 2015 European Resuscitation Council (ERC) guidelines. This study ai...

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Autores principales: Wagner, Henrik, Hardig, Bjarne Madsen, Rundgren, Malin, Zughaft, David, Harnek, Jan, Götberg, Matthias, Olivecrona, Göran K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721004/
https://www.ncbi.nlm.nih.gov/pubmed/26795941
http://dx.doi.org/10.1186/s13049-016-0198-3
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author Wagner, Henrik
Hardig, Bjarne Madsen
Rundgren, Malin
Zughaft, David
Harnek, Jan
Götberg, Matthias
Olivecrona, Göran K.
author_facet Wagner, Henrik
Hardig, Bjarne Madsen
Rundgren, Malin
Zughaft, David
Harnek, Jan
Götberg, Matthias
Olivecrona, Göran K.
author_sort Wagner, Henrik
collection PubMed
description BACKGROUND: Resuscitation after cardiac arrest (CA) in the catheterization laboratory (cath-lab) using mechanical chest compressions (CC) during simultaneous percutaneous coronary intervention (PCI) is a strong recommendation in the 2015 European Resuscitation Council (ERC) guidelines. This study aimed at re-evaluating survival to hospital discharge and assess long term outcome in this patient population. METHODS: Patients presenting at the cath lab with spontaneous circulation, suffering CA and requiring prolonged mechanical CC during cath lab procedures between 2009 and 2013 were included. Circumstances leading to CA, resuscitation parameters and outcomes were evaluated within this cohort. For comparison, patients needing prolonged manual CC in the cath lab in the pre-mechanical CC era were evaluated. Six-month and one year survival with a mechanical CC treatment strategy from 2004 to 2013 was also evaluated. RESULTS: Thirty-two patients were included between 2009 and 2013 (24 ST-elevation myocardial infarction (STEMI), 4 non-STEMI, 2 planned PCI, 1 angiogram and 1 intra-aortic counter pulsation balloon pump insertion). Twenty were in cardiogenic shock prior to inclusion. Twenty-five were successfully treated with PCI. Median mechanical CC duration for the total cohort (n = 32) was 34 min (range 5–90), for the 15 patients with circulation discharged from the cath-lab, 15 min (range 5–90), and for the eight discharged alive from hospital, 10 min (range 5–52). Twenty-five percent survived with good neurological outcome at hospital discharge. Ten patients treated with manual CC were included with one survivor. DISCUSSION: Eighty-seven percent of the patients included in the mechanical CC cohort had their coronary or cardiac intervention performed during mechanical CC with an 80 % success rate. This shows that the use of mechanical CC during an intervention does not seem to impair the interventional result substantially. The survival rate after one year was 87 %. CONCLUSIONS: Among patients suffering CA treated with mechanical CC in the cath-lab, 25 % had a good neurological outcome at hospital discharge compared to 10 % treated with manual CC. Long term survival in patients discharged from hospital is good.
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spelling pubmed-47210042016-01-22 Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts Wagner, Henrik Hardig, Bjarne Madsen Rundgren, Malin Zughaft, David Harnek, Jan Götberg, Matthias Olivecrona, Göran K. Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Resuscitation after cardiac arrest (CA) in the catheterization laboratory (cath-lab) using mechanical chest compressions (CC) during simultaneous percutaneous coronary intervention (PCI) is a strong recommendation in the 2015 European Resuscitation Council (ERC) guidelines. This study aimed at re-evaluating survival to hospital discharge and assess long term outcome in this patient population. METHODS: Patients presenting at the cath lab with spontaneous circulation, suffering CA and requiring prolonged mechanical CC during cath lab procedures between 2009 and 2013 were included. Circumstances leading to CA, resuscitation parameters and outcomes were evaluated within this cohort. For comparison, patients needing prolonged manual CC in the cath lab in the pre-mechanical CC era were evaluated. Six-month and one year survival with a mechanical CC treatment strategy from 2004 to 2013 was also evaluated. RESULTS: Thirty-two patients were included between 2009 and 2013 (24 ST-elevation myocardial infarction (STEMI), 4 non-STEMI, 2 planned PCI, 1 angiogram and 1 intra-aortic counter pulsation balloon pump insertion). Twenty were in cardiogenic shock prior to inclusion. Twenty-five were successfully treated with PCI. Median mechanical CC duration for the total cohort (n = 32) was 34 min (range 5–90), for the 15 patients with circulation discharged from the cath-lab, 15 min (range 5–90), and for the eight discharged alive from hospital, 10 min (range 5–52). Twenty-five percent survived with good neurological outcome at hospital discharge. Ten patients treated with manual CC were included with one survivor. DISCUSSION: Eighty-seven percent of the patients included in the mechanical CC cohort had their coronary or cardiac intervention performed during mechanical CC with an 80 % success rate. This shows that the use of mechanical CC during an intervention does not seem to impair the interventional result substantially. The survival rate after one year was 87 %. CONCLUSIONS: Among patients suffering CA treated with mechanical CC in the cath-lab, 25 % had a good neurological outcome at hospital discharge compared to 10 % treated with manual CC. Long term survival in patients discharged from hospital is good. BioMed Central 2016-01-21 /pmc/articles/PMC4721004/ /pubmed/26795941 http://dx.doi.org/10.1186/s13049-016-0198-3 Text en © Wagner et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Wagner, Henrik
Hardig, Bjarne Madsen
Rundgren, Malin
Zughaft, David
Harnek, Jan
Götberg, Matthias
Olivecrona, Göran K.
Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title_full Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title_fullStr Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title_full_unstemmed Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title_short Mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
title_sort mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721004/
https://www.ncbi.nlm.nih.gov/pubmed/26795941
http://dx.doi.org/10.1186/s13049-016-0198-3
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