Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation
Background: Recent trials suggested that extracorporeal cardio-pulmonary resuscitation (ECPR) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or “ECMELLA” (VA-ECMO plus Impella®) may improve short-term survival and neurological outcomes in selected patients with refractory cardiac a...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000256 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823864265945120768 |
|---|---|
| author | Tharusan Thevathasan Vanessa Wahl Joshua Boettel Megan Kenny Julia Paul Sophie Selzer Abdulla Al Harbi Eva-Maria Dorsch Heinrich Audebert Matthias Rose Christoph Paul Klapproth Sonia Lech Katharina Schmitt Steffen Desch Ulf Landmesser Ralf Westenfeld Fabian Voss Carsten Skurk |
| author_facet | Tharusan Thevathasan Vanessa Wahl Joshua Boettel Megan Kenny Julia Paul Sophie Selzer Abdulla Al Harbi Eva-Maria Dorsch Heinrich Audebert Matthias Rose Christoph Paul Klapproth Sonia Lech Katharina Schmitt Steffen Desch Ulf Landmesser Ralf Westenfeld Fabian Voss Carsten Skurk |
| author_sort | Tharusan Thevathasan |
| collection | DOAJ |
| description | Background: Recent trials suggested that extracorporeal cardio-pulmonary resuscitation (ECPR) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or “ECMELLA” (VA-ECMO plus Impella®) may improve short-term survival and neurological outcomes in selected patients with refractory cardiac arrest. However, long-term effects on cardiac, cognitive, physical and psychological health need further study. A multidisciplinary post-ECPR outpatient care program was developed at two centers, involving cardiologists, neurologists, psychologists and medical sociologists to assess seven key health dimensions. Methods: This bicentric, multidisciplinary study, conducted from May 2021 to April 2023, included adult ECPR survivors. Outcomes were assessed approximately 22 months post-cardiac arrest, focusing on cardiac, neurological, psychological and multi-organ functions, as well as social, professional and physical performance. Results: This study included 33 ECPR survivors, who were predominantly male (70%) with a mean age of 55 years. Left-ventricular ejection fraction improved significantly, from 22% during ICU stay to 51% at follow-up in the ECMELLA group and from 31% to 51% in the VA-ECMO group (p = 0.006). Many patients reported dizziness or dyspnea (>52%) during daily activities, with a median New York Heart Association class of 2, EQ-5D-5L score of 53 and elevated NT-proBNP levels. Despite normal neurological scores, 46% had memory issues, 39% struggled with daily organization, 52% had depression and 12% had suicidal thoughts. Physical performance was reduced, with a mean distance of 394 meters in the 6-minute walk test and a 6-minute bicycle ergometry time. Conclusion: ECPR patients showed significant improvement in left ventricular function over time but their neuropsychological and physical abilities remained compromised. Timely, multidisciplinary rehabilitation is required, starting in the intensive care unit and extending to include psychological support and community reintegration strategies after discharge. |
| format | Article |
| id | doaj-art-a6db12cfd0314f999e0acbe8445e9bd8 |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-a6db12cfd0314f999e0acbe8445e9bd82025-02-09T05:01:30ZengElsevierResuscitation Plus2666-52042025-03-0122100888Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitationTharusan Thevathasan0Vanessa Wahl1Joshua Boettel2Megan Kenny3Julia Paul4Sophie Selzer5Abdulla Al Harbi6Eva-Maria Dorsch7Heinrich Audebert8Matthias Rose9Christoph Paul Klapproth10Sonia Lech11Katharina Schmitt12Steffen Desch13Ulf Landmesser14Ralf Westenfeld15Fabian Voss16Carsten Skurk17Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung, Partner Seite Berlin, Berlin, Germany; Corresponding authors at: Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, 12203 Berlin, Germany.Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, GermanyNeuroscience Clinical Research Center, Charité -Universitätsmedizin Berlin, Berlin, GermanyCenter for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyDepartment of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, GermanyDepartment of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Virchow Klinikum, Berlin, GermanyDepartment of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Leipzig, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung, Partner Seite Berlin, Berlin, GermanyDivision of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, GermanyDivision of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung, Partner Seite Berlin, Berlin, Germany; Corresponding authors at: Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, 12203 Berlin, Germany.Background: Recent trials suggested that extracorporeal cardio-pulmonary resuscitation (ECPR) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or “ECMELLA” (VA-ECMO plus Impella®) may improve short-term survival and neurological outcomes in selected patients with refractory cardiac arrest. However, long-term effects on cardiac, cognitive, physical and psychological health need further study. A multidisciplinary post-ECPR outpatient care program was developed at two centers, involving cardiologists, neurologists, psychologists and medical sociologists to assess seven key health dimensions. Methods: This bicentric, multidisciplinary study, conducted from May 2021 to April 2023, included adult ECPR survivors. Outcomes were assessed approximately 22 months post-cardiac arrest, focusing on cardiac, neurological, psychological and multi-organ functions, as well as social, professional and physical performance. Results: This study included 33 ECPR survivors, who were predominantly male (70%) with a mean age of 55 years. Left-ventricular ejection fraction improved significantly, from 22% during ICU stay to 51% at follow-up in the ECMELLA group and from 31% to 51% in the VA-ECMO group (p = 0.006). Many patients reported dizziness or dyspnea (>52%) during daily activities, with a median New York Heart Association class of 2, EQ-5D-5L score of 53 and elevated NT-proBNP levels. Despite normal neurological scores, 46% had memory issues, 39% struggled with daily organization, 52% had depression and 12% had suicidal thoughts. Physical performance was reduced, with a mean distance of 394 meters in the 6-minute walk test and a 6-minute bicycle ergometry time. Conclusion: ECPR patients showed significant improvement in left ventricular function over time but their neuropsychological and physical abilities remained compromised. Timely, multidisciplinary rehabilitation is required, starting in the intensive care unit and extending to include psychological support and community reintegration strategies after discharge.http://www.sciencedirect.com/science/article/pii/S2666520425000256Cardiac arrestExtracorporeal cardio-pulmonary resuscitationPost-resuscitation programPsychological effectMyocardial recovery |
| spellingShingle | Tharusan Thevathasan Vanessa Wahl Joshua Boettel Megan Kenny Julia Paul Sophie Selzer Abdulla Al Harbi Eva-Maria Dorsch Heinrich Audebert Matthias Rose Christoph Paul Klapproth Sonia Lech Katharina Schmitt Steffen Desch Ulf Landmesser Ralf Westenfeld Fabian Voss Carsten Skurk Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation Resuscitation Plus Cardiac arrest Extracorporeal cardio-pulmonary resuscitation Post-resuscitation program Psychological effect Myocardial recovery |
| title | Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| title_full | Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| title_fullStr | Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| title_full_unstemmed | Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| title_short | Multi-dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| title_sort | multi dimensional outcomes following extracorporeal cardiopulmonary resuscitation |
| topic | Cardiac arrest Extracorporeal cardio-pulmonary resuscitation Post-resuscitation program Psychological effect Myocardial recovery |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000256 |
| work_keys_str_mv | AT tharusanthevathasan multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT vanessawahl multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT joshuaboettel multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT megankenny multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT juliapaul multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT sophieselzer multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT abdullaalharbi multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT evamariadorsch multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT heinrichaudebert multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT matthiasrose multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT christophpaulklapproth multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT sonialech multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT katharinaschmitt multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT steffendesch multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT ulflandmesser multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT ralfwestenfeld multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT fabianvoss multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation AT carstenskurk multidimensionaloutcomesfollowingextracorporealcardiopulmonaryresuscitation |