Reply: Different criteria for initiating extracorporeal cardiopulmonary resuscitation influence clinical results

• DOI: 10.1016/j.xjon.2023.02.001
• Publication Date: 2023-02-06T18:56:36Z
• Authors: Mingming Li; Kerong Zhai; Shilin Wei; Yongnan Li
• Keywords: Extracorporeal cardiopulmonary resuscitation

The authors reported no conflicts of interest.The Journal policy requires editors and reviewers to disclose interest decline handling or reviewing manuscripts for which they may have a conflict interest. this article We appreciate the thoughtful comments related our recent study team would certainly be interested in studying clinical data from Condello's1Condello I. Impact between favorable unfavorable criteria initiating ECPR outcomes.J Thorac Cardiovasc Surg Open. 2023; 13: 214Scopus (1) Google Scholar assessments with extracorporeal cardiopulmonary resuscitation (ECPR). Condello1Condello focused on outcomes 50 patients who underwent show influence outcomes, including neurological, cardiovascular, reperfusion syndrome, ischemic injury, kidney failure.1Condello Among these probability syndrome injury was highest. Unfavorable were significantly more likely various adverse outcomes. It is helpful predict essential patient should included decision making received ECPR. Recent European Resuscitation Guidelines2Lott C. Truhlář A. Alfonzo Barelli González-Salvado V. Hinkelbein J. et al.European Council Guidelines 2021: cardiac arrest special circumstances.Resuscitation. 2021; 161: 152-219Abstract Full Text PDF PubMed Scopus (209) provide recommendation that considered rescue method when conventional CPR fails. However, guidelines studies do not sufficient practice. Inoue colleagues3Inoue Hifumi T. Sakamoto Okamoto H. Kunikata Yokoi al.Extracorporeal adult out-of-hospital arrest: retrospective large cohort multicenter Japan.Crit Care. 2022; 26: 129Crossref (10) applied 1644 experiencing showed proportion neurological at hospital discharge 14.1%, survival rate 27.2%, complications observed during 32.7%. Although effectively increases overall survival, better characterization long-term needed. Previous treatment mainly concentrated nervous system, cardiovascular renal failure, hemorrhage. Neither physician-adjudicated rhythm nor underlying origin associated discharge. Younger age survival. Arrest due heart disease, initial shockable rhythm, arrest, low-flow time, continuous replacement therapy significant predictors in-hospital mortality. Establishing programs stringent compliance institutional (mainly age, witnessed time prehospital resuscitation) providing strictly selected seems vital factor good Our research shows lead systemic cerebral inflammatory reactions poor prognosis, but specific mechanism needs further study. Whether target temperature management improves results still controversial. Wang colleagues4Wang C.H. Lin Y.T. Chou H.W. Y.C. Hwang J.J. Gilbert J.R. al.Novel approach independent control brain hypothermia normothermia: selective deep refractory arrest.J Neurointerv Surg. 2017; 9: e32Crossref (7) (<30 °C) arrest. discharged without deficit 32 days after consider hypothermic perfusion new protect resuscitation.5Zhai K. Li M. Wei S. Z. Zhang Y. al.Neuroprotective effect resuscitation: preclinical study.J 12: 221-233Scopus (2) upcoming focus molecular combined alleviate injury. With many problems regarding cause sequelae being studied, evidence are required understand dilemma better. outcomesJTCVS OpenVol. 13PreviewNeurologic seriously affect quality life (ECPR) undergoing arrest.1 Full-Text Open Access