INTRODUCTION Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory in-hospital cardiac arrest has been associated with improved survival compared with conventional cardiopulmonary resuscitation (CPR). Perioperative patients represent a unique of the inpatient population. This study aims to describe and analyze the characteristics and outcomes of patients who received ECPR for perioperative cardiac arrest (POCA). METHODS A single-center retrospective review of perioperative ECPR in adults from January 2015 to August 2022 was performed. Patient demographics, cardiac arrest variables, and outcome data were obtained and analyzed. The primary study outcome was survival with favorable neurologic outcome. RESULTS A total of 33 patients received ECPR for POCA. Of the 33 patients, 24 (73%) had a cardiac arrest in the cardiac catheterization lab, while 9 (27%) had a cardiac arrest in the operating room or interventional radiology suite. Survival to discharge was 57.6%, of which 17 (89.5%) had neurologically favorable outcomes with cerebral performance category (CPC) scores of 1 or 2 at discharge. The mean total CPR time was significantly lower in the survivor group than in the non-survivor group (16.5 vs. 25.0 min, p<0.05). Survivors had significantly lower lactate levels (73 mg/dL vs. 115 mg/dL, p=0.005) and higher pH levels (7.17 vs 7.03, p=0.005) compared with non-survivors. CONCLUSIONS The use of ECPR for adults with POCA can be associated with excellent survival with neurologically favorable outcomes in carefully selected patients. Longer CPR time, higher lactate levels, and lower pH were associated with increased mortality. Given the small sample size, no other prognostic factors were identified, though certain trends were detected between survival groups.

中文翻译：

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成人围手术期体外心肺复苏：单中心回顾性回顾和分析。


引言 与传统心肺复苏 （CPR） 相比，体外心肺复苏 （ECPR） 治疗难治性院内心脏骤停与生存率的提高有关。围手术期患者代表了住院患者群体中的独特性。本研究旨在描述和分析接受 ECPR 围手术期心脏骤停 （POCA） 的患者的特征和结果。方法 对 2015年1月至 2022年8月成人围手术期 ECPR 进行单中心回顾性分析。获取并分析患者人口统计学、心脏骤停变量和结果数据。主要研究结局是存活率和良好的神经系统结局。结果 共有 33 例患者接受了 POCA 的 ECPR。在 33 名患者中，24 名 （73%） 在心导管室发生心脏骤停，而 9 名 （27%） 在手术室或介入放射科室发生心脏骤停。出院存活率为 57.6%，其中 17 例 （89.5%） 的神经系统结局良好，出院时脑功能类别 （CPC） 评分为 1 或 2。幸存者组的平均总 CPR 时间显著低于非幸存者组 （16.5 vs. 25.0 min，p<0.05）。与非幸存者相比，幸存者的乳酸水平显着降低 （73 mg/dL vs. 115 mg/dL，p=0.005） 和较高的 pH 值 （7.17 vs. 7.03，p=0.005）。结论 ECPR 用于 POCA 成人患者与精心挑选的患者的良好生存率和神经系统良好的结果相关。较长的 CPR 时间、较高的乳酸水平和较低的 pH 值与死亡率增加相关。鉴于样本量小，未发现其他预后因素，但在存活组之间检测到某些趋势。