Date of Award

8-5-2020

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Vanessa Bester, EdD, PA-C

Abstract

In this retrospective review, the use of extracorporeal cardiopulmonary resuscitation (ECPR) using extracorporeal membrane oxygenation (ECMO) was assessed in the management of refractory ventricular fibrillation (VF) and ventricular tachycardia (VT) out-of-hospital cardiac arrest (OHCA). Multiple factors were evaluated such as the duration of manual or mechanical cardiopulmonary resuscitation (CPR), ECPR protocols and the rate of favorable neurologic outcomes for these OHCA patients. Survival with a favorable neurologic outcome is defined as cerebral performance categories (CPC) 1 or 2. Although CPR remains and will continue to be a critical component in the management of cardiac arrest, the persistently high mortality rate of the condition warrants further intervention. Established ECPR protocols include timely administration of emergency intervention, patient inclusion and exclusion criteria, mechanical CPR, specific cannulation technique, percutaneous coronary intervention (PCI), as well as post-catheterization lab management. These protocols have shown encouraging initial results with an increased rate of survival with a favorable neurologic outcome when compared to management of similar patients with conventional CPR alone. This literature review found that there is strong evidence supporting the use of ECPR with ECMO support in the management of refractory VF/VT OHCA. Although there exists the need for more randomized control trials, implementation of ECMO and ECPR programs have shown to improve neurological outcomes for these patients.

Identifier

SC 11.PAS.2020.Lund.T

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