• Alexis Cournoyer, Éric Notebaert, Luc de Montigny, Sylvie Cossette, Luc Londei-Leduc, Massimiliano Iseppon, Yoan Lamarche, Catalina Sokoloff, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Dave Ross, Dominique Lafrance, Eli Segal, Yiorgos Alexandros Cavayas, Jean Paquet, and André Denault.
• Université de Montréal, Montréal, Québec, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Institut de Cardiologie de Montréal, Montréal, Québec, Canada. Electronic address: alexis.cournoyer@umontreal.ca.
• Resuscitation. 2017 Oct 1; 119: 37-42.

AimA change in prehospital redirection practice could potentially increase the proportion of E-CPR eligible patients with out-of-hospital cardiac arrest (OHCA) transported to extracorporeal cardiopulmonary resuscitation (E-CPR) capable centers. The objective of this study was to quantify this potential increase of E-CPR candidates transported to E-CPR capable centers.MethodsAdults with non-traumatic OHCA refractory to 15min of resuscitation were selected from a registry of adult OHCA collected between 2010 and 2015 in Montreal, Canada. Using this cohort, three simulation scenarios allowing prehospital redirection to E-CPR centers were created. Stringent eligibility criteria for E-CPR and redirection for E-CPR (e.g. age <60years old, initial shockable rhythm) were used in the first scenario, intermediate eligibility criteria (e.g. age <65years old, at least one shock given) in the second scenario and inclusive eligibility criteria (e.g. age <70years old, initial rhythm ≠ asystole) in the third scenario. All three scenarios were contrasted with equivalent scenarios in which patients were transported to the closest hospital. Proportions were compared using McNemar's test.ResultsThe proportion of E-CPR eligible patients transported to E-CPR capable centers increased in each scenario (stringent criteria: 48 [24.5%] vs 155 patients [79.1%], p<0.001; intermediate criteria: 81 [29.6%] vs 262 patients [95.6%], p<0.001; inclusive criteria: 238 [23.9%] vs 981 patients [98.5%], p<0.001).ConclusionsA prehospital redirection system could significantly increase the number of patients with refractory OHCA transported to E-CPR capable centers, thus increasing their access to this potentially life-saving procedure, provided allocated resources are planned accordingly.Copyright © 2017 Elsevier B.V. All rights reserved.

25 keywords...

hide…