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Importance of Maintaining Pulsatility after Extracorporeal Cardiopulmonary Resuscitation
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  • Seok In Lee,
  • Yong Su Lim,
  • Chul Hyun Park,
  • Woo Sung Choi,
  • Chang Hyu Choi
Seok In Lee
Gachon University Gil Medical Center
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Yong Su Lim
Gachon University Gil Medical Center
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Chul Hyun Park
Gachon University Gil Medical Center
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Woo Sung Choi
Gachon University Gil Medical Center
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Chang Hyu Choi
Gachon University Gil Medical Center
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Abstract

Background: Recent reports have revealed better clinical outcomes with extracorporeal cardiopulmonary resuscitation (ECPR) than with conventional cardiopulmonary resuscitation (CPR) for patients with refractory cardiac arrest. This study attempted to investigate favorable predictors of pre-, intra-, and post-ECPR for successful weaning off extracorporeal membrane oxygenation (ECMO) support. Methods: We enrolled 30 ECPR patients aged over 18 years old between August 2016 and January 2019. All clinical data were retrospectively collected. The primary endpoint was that the patient was weaned off ECMO support after ECPR. Patients were divided into two groups based on successful weaning off ECMO support (Weaned vs. Failed). Results: Fourteen patients were in the weaned group. These patients were significantly younger and have shorter CPR duration than those in the failed group (p = 0.03, < 0.01). Age, CPR duration, ECMO complications and loss of pulsatility were significantly confirmed as predictive factors for successful weaning off ECMO support through univariate logistic regression analysis. However, loss of pulsatility and CPR duration remained predictors of the favorable outcome of weaning off ECMO support after ECPR by two models of multivariate logistic regression analysis. Conclusion: We conclude that CPR duration and loss of pulsatility are predictive factors of successful weaning off from ECMO support after ECPR. Loss of pulsatility relates to management during post-ECPR, unlike CPR duration. In patients with decreased pulsatility after ECPR, careful management is warranted because the loss of pulsatility is closely associated with weaning off ECMO support after ECPR.

Peer review status:IN REVISION

16 May 2020Submitted to Journal of Cardiac Surgery
19 May 2020Submission Checks Completed
19 May 2020Assigned to Editor
24 May 2020Reviewer(s) Assigned
30 May 2020Review(s) Completed, Editorial Evaluation Pending
08 Jun 2020Editorial Decision: Revise Major
26 Jun 20201st Revision Received
27 Jun 2020Submission Checks Completed
27 Jun 2020Assigned to Editor
07 Jul 2020Reviewer(s) Assigned
07 Jul 2020Review(s) Completed, Editorial Evaluation Pending
01 Aug 2020Editorial Decision: Revise Major
13 Aug 20202nd Revision Received
14 Aug 2020Assigned to Editor
14 Aug 2020Submission Checks Completed