Effect of Mean Blood Pressure During Extracorporeal Life Support on Outcome After Out-of-Hospital Cardiac Arrest [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. 2019; 47(2): 134-141 | DOI: 10.5152/TJAR.2019.73558  

Effect of Mean Blood Pressure During Extracorporeal Life Support on Outcome After Out-of-Hospital Cardiac Arrest

Romain Jouffroy, Alexandra Guyard, Pascal Philippe, Pierre Carli, Benoit Vivien
Intensive Care Unit, Anaesthesiology Department and SAMU of Paris, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France

Objective: Extracorporeal Life Support (ECLS) can help to improve the outcome of refractory cardiac arrest (CA). ECLS allows to maintain blood pressure and tissue perfusion until the cause of CA is treated. The aim of the present study was to describe the mean blood pressure (MBP) during the first 24 h of ECLS for out-of-hospital CA (OHCA).
Methods: We performed a retrospective analysis of consecutive refractory OHCA requiring ECLS admitted to the intensive care unit. MBP was examined after starting ECLS (H0) and every 6 h during the first 24 h (H6, H12, H18 and H24).
Results: Forty patients were analysed. MBP significantly differs between survivors and non-survivors since 6 h: 77 vs 44 mm Hg (p=0.002), 51 vs 87 mm Hg at H12 (p=0.008), 57 vs 75 mm Hg at H18 (p=0.015) and 79 vs 53 mm Hg at H24 (p=0.004), whereas no difference was observed at H0: 69 vs 55 mm Hg (p=0.06). An MBP lower than 65 mm Hg since 6 h is associated with a poor outcome (sensitivity and specificity of death of 87% and 66% at H6, 80% and 75% at H12, 100% and 75% at H18 and 70% and 80% at H24, respectively).
Conclusion: Despite high levels of catecholamine, the inability to maintain MBP higher than 60 mm Hg after starting ECLS for OHCA is associated with a poor outcome.

Keywords: Extracorporeal life support, mean blood pressure, outcome, out-of-hospital cardiac arrest


Romain Jouffroy, Alexandra Guyard, Pascal Philippe, Pierre Carli, Benoit Vivien. Effect of Mean Blood Pressure During Extracorporeal Life Support on Outcome After Out-of-Hospital Cardiac Arrest. Turk J Anaesthesiol Reanim. 2019; 47(2): 134-141

Corresponding Author: Romain Jouffroy, France


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