Extracorporeal Life Support and New Therapeutic Strategies for Cardiac Arrest Caused by Acute Myocardial Infarction - a Critical Approach for a Critical Condition

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Abstract

This review summarizes the most recent developments in providing advanced supportive measures for cardiopulmonary resuscitation, and the results obtained using these new therapies in patients with cardiac arrest caused by acute myocardial infarction (AMI). Also detailed are new approaches such as extracorporeal cardiopulmonary resuscitation (ECPR), intra-arrest percutaneous coronary intervention, or the regional models for systems of care aiming to reduce the critical times from cardiac arrest to initiation of ECPR and coronary revascularization.

1. Chen HY, Gore JM, Lapane KL, et al. A 35-Year Perspective (1975 to 2009) into the Long-Term Prognosis and Hospital Management of Patients Discharged from the Hospital After a First Acute Myocardial Infarction. Am J Cardiol. 2015;116:24-9. doi: 10.1016/j.amjcard.2015.03.035.

2. Islam S, Hampton-Till J, Mohd Nazri S, et al. Setting Up an Efficient Therapeutic Hypothermia Team in Conscious ST Elevation Myocardial Infarction Patients: A UK Heart Attack Center Experience. Ther Hypothermia Temp Manag. 2015;5:217-22. doi: 10.1089/ther.2015.0012.

3. Gyongyosi M, Hemetsberger R, Posa A, et al. Hypoxia-inducible Factor 1-Alp[ha Release After Intracoronary versus Intramyocardial Stem Cell Therapy in Myocardial Infarction. J Cardiovasc Translational Res. 2010;3:114-21. doi: 10.1007/s12265-009-9154-1.

4. Benedek I, Gyongyosi M, Benedek T. A prospective regional registry of ST-elevation myocardial infarction in central Romania. Impact of the Stent for Life initiative recommendations on patient outcomes. Am Heart J. 2013;166:457-65. doi: 10.1016/j.ahj.2013.03.033.

5. Avalli L, Maggioni E, Formica F, et al. Favourable survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: an Italian tertiary care centre experience. Resuscitation. 2012;83:579-83. doi: 10.1016/j.resuscitation.2011.10.013.

6. Dworschak M. Is extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest superior compared with conventional resuscitation? Crit Care Med. 2013;41:1365-6. doi: 10.1097/CCM.0b013e31828044c0.

7. Le Guen M, Nicolas-Robin A, Carreira S, et al. Extracorporeal life support following out-of-hospital refractory cardiac arrest. Crit Care. 2011;15:R29. doi: 10.1186/cc9976.

8. Fagnoul D, Taccone FS, Belhaj A, et al. Extracorporeal life support associated with hypothermia and normoxemia in refractory cardiac arrest. Resuscitation. 2013;84:1519-24. doi: 10.1016/j.resuscitation.2013.06.016.

9. Lamhaut L, Jouffroy R, Kalpodjian A, et al. Successful treatment of refractory cardiac arrest by emergency physicians using pre-hospital ECLS. Resuscitation. 2012;83:e177-e178. doi: 10.1016/j.resuscitation.2012.03.016

10. Mojoli F, Venti A, Pellegrini C, et al. Hospital survival and long-term quality of life after emergency institution of venoarterial ECMO for refractory circulatory collapse. Minerva Anestesiol. 2013;79:1147-55.

11. Wang CH, Chen YS, Ma MH. Extracorporeal life support. Curr Opin Crit Care. 2013;19:202-07. doi: 10.1097/MCC.0b013e32836092a1.

12. Lee JJ, Han SJ, Kim HS, et al. Out-of-hospital cardiac arrest patients treated with cardiopulmonary resuscitation using extracorporeal membrane oxygenation: focus on survival rate and neurologic outcome. Scand J Trauma Resusc Emerg Med. 2016;24:74. doi: 10.1186/s13049-016-0266-8.

13. Kagawa E. Extracorporeal cardiopulmonary resuscitation for adult cardiac arrest patients. World J Crit Care Med. 2012;1:46-9. doi: 10.5492/wjccm.v1.i2.46.

14. Kagawa E, Inoue I, Kawagoe T, et al. Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest patients treated with cardiopulmonary resuscitation using extracorporeal life support. Resuscitation. 2010;81:968-73. doi: 10.1016/j.resuscitation.2010.03.037.

15. Patroniti N, Sangalli F, Avalli L. Post-cardiac arrest extracorporeal life support. Best Pract Res Clin Anaesthesiol. 2015;29:497-508. doi: 10.1016/j.bpa.2015.09.004.

16. Tonna JE, Johnson NJ, Greenwood J, et al. Practice characteristics of Emergency Department extracorporeal cardiopulmonary resuscitation (eCPR) programs in the United States: The current state of the art of Emergency Department extracorporeal membrane oxygenation (ED ECMO). Resuscitation. 2016;107:38-46. doi: 10.1016/j.resuscitation.2016.07.237.

17. Teschendorf P, Bernhard M. A bridge to life: ECPR who, when, where and why? Resuscitation. 2014;85:709-10. doi: 10.1016/j.resuscitation.2014.03.315.

18. Rousse N, Robin E, Juthier F, et al. Extracorporeal Life Support in Out-of-Hospital Refractory Cardiac Arrest. Artif Organs. 2016;40:904-9. doi: 10.1111/aor.12655.

19. Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132 (18Suppl2):S444-64. doi: 10.1161/CIR.0000000000000261.

20. Dalle Ave AL, Shaw DM, Gardiner D. Extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation or uncontrolled donation after the circulatory determination of death following out-of-hospital refractory cardiac arrest - An ethical analysis of an unresolved clinical dilemma. Resuscitation. 2016;pii:S0300-9572(16)30150-2. doi: 10.1016/j.resuscitation.2016.07.003 [Epub ahead of print]

21. Mancini ME, Diekema DS, Hoadley TA, et al. Part 3: Ethical Issues: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18Suppl2):S383-S396. doi: 10.1161/CIR.0000000000000254.

22. Lin JW, Wang MJ, Yu HY, et al. Comparing the survival between extracorporeal rescue and conventional resuscitation in adult in-hospital cardiac arrests: propensity analysis of three-year data. Resuscitation. 2010;81:796-803. doi: 10.1016/j.resuscitation.2010.03.002.

23. Biderman P, Kagan I, Jakobishvili Z, Fainblut M, Lishetzinsky Y, Cohen J. Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest. Isr Med Assoc J. 2016;18:61-2.

24. Choi DS, Kim T, Ro YS, et al. Extracorporeal life support and survival after out-of-hospital cardiac arrest in a nationwide registry: A propensity score-matched analysis. Resuscitation. 2016;99:26-32. doi: 10.1016/j.resuscitation.2015.11.013.

25. Flannigan C, Bourke TW, Chisakuta A. Out-of-hospital extracorporeal life support-when is it appropriate? Resuscitation. 2012;83:e85. doi: 10.1016/j.resuscitation.2011.08.030.

26. Fukuda T, Nakamura K, Fukuda-Ohashi N, Yahagi N. How long should resuscitative efforts be continued in adult out-of-hospital cardiac arrest? Can J Cardiol. 2015;31:364.e1-2. doi: 10.1016/j.cjca.2014.11.028.

27. Ha TS, Yang JH, Cho YH, et al. Clinical outcomes after rescue extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Emerg Med J. 2016;pii:emermed-2015-204817. doi: 10.1136/emermed-2015-204817 [Epub ahead of print].

28. Maekawa K, Tanno K, Hase M, Mori K, Asai Y. Extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest of cardiac origin: a propensity-matched study and predictor analysis. Crit Care Med. 2013;41:1186-96. doi: 10.1097/CCM.0b013e31827ca4c8.

29. Putzer G, Mair B, Hangler H, Ströhle M, Mair P. Emergency extracorporeal life support after prolonged out-of-hospital cardiac arrest. J Cardiothorac Vasc Anesth. 2014;28:1024-26. doi: 10.1053/j.jvca.2013.12.016.

30. Ortega-Deballon I, Hornby L, Shemie SD, Bhanji F, Guadagno E. Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: A systematic review of international practices and outcomes. Resuscitation. 2016;101:12-20. doi: 10.1016/j.resuscitation.2016.01.018.

31. Sawyer KN, Kurz MC. Caution when defining prolonged downtime in out of hospital cardiac arrest as extracorporeal cardiopulmonary resuscitation becomes accessible and feasible. Resuscitation. 2014;85:979-80. doi: 10.1016/j.resuscitation.2014.05.018.

32. Wang CH, Chou NK, Becker LB, et al. Improved outcome of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest- a comparison with that for extracorporeal rescue for in-hospital cardiac arrest. Resuscitation. 2014;85:1219-24. doi: 10.1016/j.resuscitation.2014.06.022.

33. Ahn C, Kim W, Cho Y, Choi KS, Jang BH, Lim TH. Efficacy of extracorporeal cardiopulmonary resuscitation compared to conventional cardiopulmonary resuscitation for adult cardiac arrest patients: a systematic review and meta-analysis. Sci Rep. 2016;6:34208. doi: 10.1038/srep34208.

34. Lee YH, Oh YT, Ahn HC, et al. The prognostic value of the grey-to-white matter ratio in cardiac arrest patients treated with extracorporeal membrane oxygenation. Resuscitation. 2016;99:50-5. doi: 10.1016/j.resuscitation.2015.11.009.

35. Lee SH, Jung JS, Lee KH, Kim HJ, Son HS, Sun K. Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial? Korean J Thorac Cardiovasc Surg. 2015;48:318-27. doi: 10.5090/kjtcs.2015.48.5.318.

36. Pozzi M, Koffel C, Armoiry X, et al. Extracorporeal life support for refractory out-of-hospital cardiac arrest: Should we still fight for? A single-centre, 5-year experience. Int J Cardiol. 2016;204:70-6. doi: 10.1016/j.ijcard.2015.11.165.

37. Beppu K, Doi T, Hosokawa A, et al. Full neurological recovery, Cerebral Performance Category (CPC) 1, after 65-minute cardiac arrest using percutaneous cardiopulmonary system and therapeutic hypothermia. Int J Cardiol. 2013;168:4893-95. doi: 10.1016/j.ijcard.2013.07.024.

38. Kirkham F. Cardiac arrest and post resuscitation of the brain. Eur J Paediatr Neurol. 2011;15:379-89. doi: 10.1016/j.ejpn.2011.04.009.

39. Mochizuki K, Imamura H, Iwashita T, Okamoto K. Neurological outcomes after extracorporeal cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest: a retrospective observational study in a rural tertiary care center. J Intensive Care. 2014;2:33. doi: 10.1186/2052-0492-2-33.

40. Yagi T, Nagao K, Sakatani K, et al. Changes of cerebral oxygen metabolism and hemodynamics during ECPR with hypothermia measured by near-infrared spectroscopy: a pilot study. Adv Exp Med Biol. 2013;789:121-8. doi: 10.1007/978-1-4614-7411-1_17.

41. Nagao K, Kikushima K, Watanabe K, et al. Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention. Circ J. 2010;74:77-85.

42. Fagnoul D, Combes A, De Backer D. Extracorporeal cardiopulmonary resuscitation. Curr Opin Crit Care. 2014;20:259-65. doi: 10.1097/MCC.0000000000000098.

43. Kim SJ, Jung JS, Park JH, Park JS, Hong YS, Lee SW. An optimal transition time to extracorporeal cardiopulmonary resuscitation for predicting good neurological outcome in patients with out-of-hospital cardiac arrest: a propensity-matched study. Crit Care. 2014;18:535. doi: 10.1186/s13054-014-0535-8.

44. Benedek T, Jako B, Benedek I. Plaque Quantification by Coronary CT and Intravascular Ultrasound Identifies a Low CT Density Core as a marker of plaque instability in Acute Coronary Syndromes. International Heart J. 2014;55:22-8.

45. Farb A, Burke AP, Tang AL, et al. Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary death. Circulation. 1996; 93:1354.

46. Otani T, Sawano H, Oyama K, Morita M, Natsukawa T, Kai T. Resistance to conventional cardiopulmonary resuscitation in witnessed out-of-hospital cardiac arrest patients with shockable initial cardiac rhythm. J Cardiol. 2016;68:161-7. doi: 10.1016/j.jjcc.2015.08.020.

47. Lazzeri C, Valente S, Peris A, Gensini GF. Extracorporeal life support for out-of-hospital cardiac arrest: Part of a treatment bundle. Eur Heart J Acute Cardiovasc Care. 2015; pii:2048872615585517. DOI: 10.1177/2048872615585517 [Epub ahead of print].

48. Lazzeri C, Valente S, Peris A, Gensini GF. Extracorporeal life support treatment bundle for refractory cardiac arrest. Resuscitation. 2015;87:e5-e6. doi: 10.1016/j.resuscitation.2014.10.027.

49. Stub D, Bernard S, Pellegrino V, et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015;86:88-94. doi: 10.1016/j.resuscitation.2014.09.010.

50. Belohlavek J, Kucera K, Jarkovsky J, et al. Hyperinvasive approach to out-of hospital cardiac arrest using mechanical chest compression device, prehospital intraarrest cooling, extracorporeal life support and early invasive assessment compared to standard of care. A randomized parallel groups comparative study proposal. “Prague OHCA study”. J Transl Med. 2012;10:163. doi: 10.1186/1479-5876-10-163.

51. Kagawa E, Dote K, Kato M, et al. Should we emergently revascularize occluded coronaries for cardiac arrest?: rapid-response extracorporeal membrane oxygenation and intra-arrest percutaneous coronary intervention. Circulation. 2012;126:1605-13. DOI: 10.1161/CIRCULATIONAHA.111.067538.

52. Kagawa E, Dote K, Kihara Y. Percutaneous coronary intervention for postcardiac arrest syndrome. Curr Opin Cardiol. 2013;28:689-94. doi: 10.1097/HCO.0b013e32836553b7.

53. Sakamoto T, Morimura N, Nagao K, et al. Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study. Resuscitation. 2014;85:762-8. doi: 10.1016/j.resuscitation.2014.01.031.

54. Yamada T, Kitamura T, Hayakawa K, et al. Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan. J Intensive Care. 2016;4:10. doi: 10.1186/s40560-016-0128-5.

55. Rassaf T, Westenfeld R, Kurt M, Lichtenberg A, Kelm M. Rapid response ECLS after 140 min of refractory ventricular fibrillation following out-of-hospital cardiac arrest: feasibility as bridge to primary PCI. Resuscitation. 2014;85:e57-e59. doi: 10.1016/j.resuscitation.2013.12.029.

56. Beurtheret S, Mordant P, Paoletti X, et al. Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program). Eur Heart J. 2013;34:112-20. doi: 10.1093/eurheartj/ehs081.

57. Benedek T, Dobreanu D. Current Concepts and New Trends in the Treatment of Cardiogenic Shock Complicating Acute Myocardial Infarction. J Crit Care Med. 2015;1:5-11. DOI: 10.1515/jccm-2015-0002

58. Bărcan A, Chițu M, Benedek E, et al. Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest. J Crit Care Med. 2016;2:22-30. DOI: 10.1515/jccm-2016-0001

59. Bajka B, Orzan M, Jakó B, Kovács I. Distance-related differences in critical times, protocol activation and mortality in a regional STEMI network. Journal of Cardiovascular Emergencies. 2016;2:122-8. DOI: 10.1515/jce-2016-0019.

60. Peek GJ. Community extracorporeal life support for cardiac arrest - when should it be used? Resuscitation. 2011;82:1117. doi: 10.1016/j.resuscitation.2011.06.006.

61. Strapazzon G, Plankensteiner J, Mair P, et al. Prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest: a retrospective study in Tyrol, Austria. Eur J Emerg Med. 2016. DOI: 10.1097/MEJ.0000000000000390 [Epub ahead of print].

62. Hwang WS, Park JS, Kim SJ, Hong YS, Moon SW, Lee SW. A system-wide approach from the community to the hospital for improving neurologic outcomes in out-of-hospital cardiac arrest patients. Eur J Emerg Med. 2015. DOI: 10.1097/MEJ.0000000000000313 [Epub ahead of print].

63. Avalli L, Mauri T, Citerio G, et al. New treatment bundles improve survival in out-of-hospital cardiac arrest patients: a historical comparison. Resuscitation. 2014;85:1240-4. doi: 10.1016/j.resuscitation.2014.06.014.

64. Grunau B, Reynolds J, Scheuermeyer F, et al. Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital? Prehosp Emerg Care. 2016;20:615-22. doi: 10.3109/10903127.2016.1149652.

65. Grunau B, Scheuermeyer FX, Stub D, et al. Potential Candidates for a Structured Canadian ECPR Program for Out-of-Hospital Cardiac Arrest. CJEM. 2016:1-8. DOI: 10.1017/cem.2016.8.

66. Sharma AS, Pijls RW, Weerwind PW, et al. Out-of-hospital cardiac arrest: the prospect of E-CPR in the Maastricht region. Neth Heart J. 2016;24:120-6. doi: 10.1007/s12471-015-0782-6.

67. Yannopoulos D, Bartos JA, Martin C, et al. Minnesota Resuscitation Consortium’s Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation. J Am Heart Assoc. 2016;5:e003732. doi: 10.1161/JAHA.116.003732.

68. Arima T, Nagata O, Sakaida K, et al. Relationship between duration of prehospital resuscitation and favorable prognosis in ventricular fibrillation. Am J Emerg Med. 2015;33:677-81. doi: 10.1016/j.ajem.2015.02.031.

69. Leick J, Liebetrau C, Szardien S, et al. Door-to-implantation time of extracorporeal life support systems predicts mortality in patients with out-of-hospital cardiac arrest. Clin Res Cardiol. 2013;102:661-9. doi: 10.1007/s00392-013-0580-3.

70. Spangenberg T, Meincke F, Brooks S, et al. “Shock and Go?” extracorporeal cardio-pulmonary resuscitation in the golden-hour of ROSC. Catheter Cardiovasc Interv. 2016. doi: 10.1002/ccd.26616 [Epub ahead of print].

71. Johnson NJ, Acker M, Hsu CH, et al. Extracorporeal life support as rescue strategy for out-of-hospital and emergency department cardiac arrest. Resuscitation. 2014;85:1527-32. doi: 10.1016/j.resuscitation.2014.08.028.

72. Rubertsson S. Update on mechanical cardiopulmonary resuscitation devices. Curr Opin Crit Care. 2016;22:225-9. doi: 10.1097/MCC.0000000000000302.

73. Menegazzi JJ, Salcido DD, Housler GJ, Logue ES. Feasibility of initiating extracorporeal life support during mechanical chest compression CPR: a porcine pilot study. Resuscitation. 2012;83:130-3. doi: 10.1016/j.resuscitation.2011.07.030

74. Agostinucci JM, Ruscev M, Galinski M, et al. Out-of-hospital use of an automated chest compression device: facilitating access to extracorporeal life support or non-heart-beating organ procurement. Am J Emerg Med. 2011;29:1169-72. doi: 10.1016/j.ajem.2010.06.029.

75. Ogawa Y, Shiozaki T, Hirose T, et al. Load-distributing-band cardiopulmonary resuscitation for out-of-hospital cardiac arrest increases regional cerebral oxygenation: a single-center prospective pilot study. Scand J Trauma Resusc Emerg Med. 2015;23:99. doi: 10.1186/s13049-015-0182-3.

76. Couper K, Smyth M, Perkins GD. Mechanical devices for chest compression: to use or not to use? Curr Opin Crit Care. 2015;21:188-94. doi: 10.1097/MCC.0000000000000200.

77. Topjian AA, Naim MY, Nadkarni V. To cool or not to cool during cardiopulmonary resuscitation. World J Pediatr Congenit Heart Surg. 2012;3:54-7. doi: 10.1177/2150135111418256.

78. Kim SJ, Kim HJ, Lee HY, Ahn HS, Lee SW. Comparing extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation: A meta-analysis. Resuscitation. 2016;103:106-16. doi: 10.1016/j.resuscitation.2016.01.019.

79. Haneya A, Philipp A, Diez C, et al. A 5-year experience with cardiopulmonary resuscitation using extracorporeal life support in non-postcardiotomy patients with cardiac arrest. Resuscitation. 2012;83:1331-7. doi: 10.1016/j.resuscitation.2012.07.009.

80. Jung C, Janssen K, Kaluza M, et al. Outcome predictors in cardiopulmonary resuscitation facilitated by extracorporeal membrane oxygenation. Clin Res Cardiol. 2016;105:196-205. doi: 10.1007/s00392-015-0906-4.

81. Anselmi A, Flécher E. Extracorporeal cardiopulmonary resuscitation for out-of-hospital refractory cardiac arrest: A word of caution. J Thorac Cardiovasc Surg. 2016;151:1217-8. doi: 10.1016/j.jtcvs.2015.11.033.

82. Anselmi A, Flécher E, Corbineau H, et al. Survival and quality of life after extracorporeal life support for refractory cardiac arrest: A case series. J Thorac Cardiovasc Surg. 2015;150:947-54. doi: 10.1016/j.jtcvs.2015.05.070.

83. Flécher E, Anselmi A, Corbineau H, et al. Current aspects of extracorporeal membrane oxygenation in a tertiary referral centre: determinants of survival at follow-up. Eur J Cardiothorac Surg. 2014;46:665-71. doi: 10.1093/ejcts/ezu029.

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