The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: Program description, performance, and outcomes

Jason A. Bartos, Ralph Frascone, Marc Conterato, Keith Wesley, Charles Lick, Kevin Sipprell, Nik Vuljaj, Aaron M Burnett, Bjorn K. Peterson, Nicholas Simpson, Kealy Ham, Charles Bruen, Casey Woster, Kari B. Haley, Johanna C Moore, Brandon Trigger, Lucinda Hodgson, Kim Harkins, Marinos Kosmopoulos, Tom P AufderheideJakub Tolar, Demetris Yannopoulos

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background: We describe implementation, evaluate performance, and report outcomes from the first program serving an entire metropolitan area designed to rapidly deliver extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation to patients with refractory ventricular fibrillation/ventricular tachycardia (VF/VT) out-of-hospital cardiac arrest (OHCA). Methods: This observational cohort study analyzed consecutive patients prospectively enrolled in the Minnesota Mobile Resuscitation Consortium's ECMO-facilitated resuscitation program. Entry criteria included: 1) adults (aged 18–75), 2) VF/VT OHCA, 3) no return of spontaneous circulation following 3 shocks, 4) automated cardiopulmonary resuscitation with a Lund University Cardiac Arrest System (LUCAS™), and 5) estimated transfer time of < 30 min. The primary endpoint was functionally favorable survival to hospital discharge with Cerebral Performance Category (CPC) 1 or 2. Secondary endpoints included 3-month functionally favorable survival, program benchmarks, ECMO cannulation rate, and safety. Essential program components included emergency medical services, 3 community ECMO Initiation Hospitals with emergency department ECMO cannulation sites and 24/7 cardiac catheterization laboratories, a 24/7 mobile ECMO cannulation team, and a single, centralized ECMO intensive care unit. Findings: From December 1, 2019 to April 1, 2020, 63 consecutive patients were transported and 58 (97%) met criteria and were treated by the mobile ECMO service. Mean age was 57 ± 1.8 years; 46/58 (79%) were male. Program benchmarks were variably met, 100% of patients were successfully cannulated, and no safety issues were identified. Of the 58 patients, 25/58 (43% [CI:31–56%]) were both discharged from the hospital and alive at 3 months with CPC 1 or 2. Interpretation: This first, community-wide ECMO-facilitated resuscitation program in the US demonstrated 100% successful cannulation, 43% functionally favorable survival rates at hospital discharge and 3 months, as well as safety. The program provides a potential model of this approach for other communities. Funding: The Helmsley Charitable Trust

Original languageEnglish (US)
Article number100632
JournalEClinicalMedicine
Volume29-30
DOIs
StatePublished - Dec 2020

Bibliographical note

Funding Information:
All authors report having received funding from the Leona M. and Harry B. Helmsley Charitable Trust. JAB, TPA, and DY also received funding from the National Heart, Lung, and Blood Institute.

Funding Information:
Project funding was received from the Helmsley Charitable Trust. JAB, TPA, and DY also received funding from the National Heart, Lung, and Blood Institute.

Publisher Copyright:
© 2020 The Authors

Keywords

  • Cardiac arrest
  • Extracorporeal cardiopulmonary resuscitation
  • Extracorporeal membrane oxygenation
  • Refractory ventricular fibrillation
  • Sudden cardiac death

PubMed: MeSH publication types

  • Journal Article

Fingerprint

Dive into the research topics of 'The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: Program description, performance, and outcomes'. Together they form a unique fingerprint.

Cite this