Khoury Joelle, Soumagnac Tal, Vimpere Damien, El Morabity Assia, Hutin Alice, Raphalen Jean-Herlé, Lamhaut Lionel
SAMU de Paris and Intensive Care Unit, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris 75015, France; Sorbonne University, Paris 75013, France.
SAMU de Paris and Intensive Care Unit, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris 75015, France.
Resuscitation. 2025 Feb;207:110449. doi: 10.1016/j.resuscitation.2024.110449. Epub 2024 Nov 30.
Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on heart function in surviving patients remains unclear.
We conducted a 9 year monocentric retrospective observational study in Paris, France (January 1, 2015, to December 31, 2023). Patients were included if they had a refractory OHCA caused by ACS and were treated with prehospital ECPR. The primary outcome was the New York Heart Association Functional Classification (NYHA-FC) at one year. We also evaluated survival with good neurological outcomes (CPC 1 or 2) and left ventricular ejection fraction (LVEF) at the same time interval. Finally we assessed the ability to work in patients who were still alive.
A total of 114 patients were included, 24/114 (21 %) survived at one year with good neurological outcomes (CPC 1 or 2). Among them, the median NYHA-FC at one year was 1 (1-1), and half had recovered an LVEF > 50 %. At the time of data collection, 21 patients were still alive, with a median follow-up time of 6.8 (3.6-8.0) years. Half of these patients were actively working, with a median time of 10 months (3-21) to regain the ability to work since the onset of OHCA.
Most patients who were treated with prehospital ECPR for refractory OHCA due to ACS and survived with good neurological outcomes recovered a good heart function at one year, and half of them were working.
体外心肺复苏（ECPR）是一种用于治疗难治性院外心脏骤停（OHCA）的方法，OHCA通常由急性冠状动脉综合征（ACS）引起。然而，院外ECPR对存活患者心脏功能的长期影响仍不清楚。
我们在法国巴黎进行了一项为期9年的单中心回顾性观察研究（2015年1月1日至2023年12月31日）。纳入因ACS导致难治性OHCA并接受院外ECPR治疗的患者。主要结局是1年时的纽约心脏协会功能分级（NYHA-FC）。我们还评估了同期具有良好神经功能结局（脑功能分级[CPC]1或2）的生存率和左心室射血分数（LVEF）。最后，我们评估了仍存活患者的工作能力。
共纳入114例患者，24/114（21%）在1年时存活且具有良好的神经功能结局（CPC 1或2）。其中，1年时NYHA-FC的中位数为1（1-1），一半患者的LVEF恢复至>50%。在数据收集时，21例患者仍存活，中位随访时间为6.8（3.6-8.0）年。这些患者中有一半在积极工作，自OHCA发作以来恢复工作能力的中位时间为10个月（3-21个月）。
大多数因ACS导致难治性OHCA并接受院外ECPR治疗且存活且具有良好神经功能结局的患者在1年时心脏功能恢复良好，其中一半患者在工作。
