Table 4.
Baseline clinical characteristics and outcomes of the ECPR group and the CCPR group of studies included.
| Serum lactate/Arterial pH (mean ± [SD]/median [IQR]) |
Coronary angiography, n (%) |
Reperfusion therapy/PCI/CABG, n (%) |
ACS/AMI, n (%) |
Therapeutic hypothermia, n (%) |
Neurological outcome (CPC 1–2) at discharge, 30-day and/or long-term neurological outcome, n (%) |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Authors, year, country | ECPR | CCPR | ECPR | CCPR | ECPR | CCPR | ECPR | CCPR | ECPR | CCPR | ECPR | CCPR |
| Chen et al. 200848 Taiwan | Lactate: NR | Lactate: NR | … | … | 26 (44) | 6 (6) | 37 (63) | 80 (71) | No applied | No applied | Discharge: 14 (24) | Discharge: 12 (11) |
| pH: 12.0 | pH: 3.7 | 30-day: 14 (24) | 30-day: 12 (11) | |||||||||
| (2.4–39.7)* | (1.1–20)* | 1-year: 9 (15) | 1 year: 10 (9) | |||||||||
| Kim et al. 201445 South Korea | Lactate: 17.7 | Lactate: 10.8 | 39/44 | 11/15 | 29 (94) | 3 (100) | 36/52 (69) | 9/52 (17) | 17 (31) | 71 (16) | Discharge: 8 (14) | Discharge: 36 (8) |
| (8.8–16.0)† | (7.3–14.0)† | (89) | (73)‡ | 30-day: 8 (15) | 30-day: 36 (8) | |||||||
| pH: 6.98 | pH: 6.94 | 3-months: 8 (15) | 3-months: 36 (8) | |||||||||
| (6.86–7.05)† | (8.8–16.0)† | |||||||||||
| Maekawa et al. 201346 Japan | Lactate: NR | Lactate: NR | … | … | 21 (40)§ | 6 (6)§ | … | … | 26 (49)‖ | 7 (6)‖ | Discharge: NR | Discharge: NR |
| pH: NR | pH: NR | 30-day: NR | 30-day: NR | |||||||||
| 3 months: 15 (28) | 3-months: 5 (5) | |||||||||||
| Sakamoto et al. 201447 Japan | Lactate: NR | Lactate: NR | 157/177 (89)‖ | 25/37 | 97/177 (55)‖ | 21/37 | 165 (64) | 115 (59) | 162/167 (92) | 20/37 (54) | Discharge: NR | Discharge: NR |
| pH: NR | pH: NR | (68)‖ | (57)‖ | 30-day: 32 (12) | 30-day: 3 (1.6) | |||||||
| 6-months: 29 (11) | 6-months: 5 (3) | |||||||||||
| Shin et al. 201349 South Korea | Lactate: NR | Lactate: NR | … | … | 18 (21)§ | 11 (3)§ | 38 (45) | 82 (26) | No applied | No applied | Discharge: NR | Discharge: NR |
| pH: NR | pH: NR | 30-day: 24 (28)# | 30-day: 24 (8)# | |||||||||
| 2-years: 22 (26)# | 2-years: 22 (7)# | |||||||||||
| Siao et al. 201550 Taiwan | Lactate: 8.90 (2.29) | Lactate: 8.25 (2.29) | … | … | 12 (60)§,¶ | 16 (40)§,¶ | 12 (60) | 16 (40) | 9 (45)|| | 9 (23)|| | Discharge: 8 (40) | Discharge: 3 (8) |
| pH: NR | pH: NR | 30-day: NR | 30-day: NR | |||||||||
| 1-year: 8 (40) | 1-year: 3 (8) | |||||||||||
Abbreviations: ACS = acute coronary syndrome; AMI = acute myocardial infarction; CPR = cardiopulmonary resuscitation; CCPR = conventional cardiopulmonary resuscitation; CPC = cerebral performance category; ECPR = extracorporeal cardiopulmonary resuscitation; ECMO = extracorporeal membrane oxygenation; GABC = coronary artery bypass grafting; PCI = percutaneous coronary intervention; pH = measured acid-base balance of the blood; ROSB = return of spontaneous heartbeat; ROSC = return of spontaneous circulation.
Notes: Total percentages refer to studies with available data.
Neurologically intact survival (i.e. long-term [three months to two years]) were combined into a single category.
* Available maximal lactic acid in 24 -h period.
† Measured in 48 ECPR patients and 332 CCPR patients.
‡ In 15 suspected ACS patients with ROSC (≥ 20 min).
§ Reported as primary PCI.
‖ The contents of treatments given to 214 patients (92% of 177 patients in the ECPR group and 54% of 37 patients in the CCPR group), who were alive at 24 h after cardiac arrest. The frequencies of introducing TH and performing intra-aortic balloon pump were significantly higher in the ECPR group.
¶ Emergency coronary angiography was performed by cardiologist if acute myocardial infarction was suspected.
|| Therapeutic hypothermia was considered when the patients remain comatose after ROSB (ECPR group) or ROSC (CCPR group) and decided by the ICU attending physicians.
# Minimal neurological impairment was defined as a Modified Glasgow Outcome Score (MGOS) ≥ 4.