Cardiac arrest & resuscitation
Outcome of extracorporeal membrane oxygenation use in severe accidental hypothermia with cardiac arrest and circulatory instability: A multicentre, prospective, observational study in Japan (ICE-CRASH study)
Authors' conclusion
ECMO improved survival and neurological outcomes in AH patients with CA, but not in AH patients without CA.
Study context
- Population
- Adults with severe accidental hypothermia (body temperature ≤32 °C with cardiac arrest (CA) or circulatory instability) presenting to the ED in Japan, December 2019–March 2022severe accidental hypothermia (AH), of 499 patients
- Participants
- 242 adults
- Exposure
- ECMO vs no ECMO
- ECMOn = 41
- non-ECMOn = 201reference
- Outcome
- 28-day survival and favourable neurological outcomes at discharge
- Follow-up
- 28 days; discharge
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
28-day survival and favourable neurological outcome at discharge, patients with CA
ECMO vs non-ECMOOdds ratio (95% CI)
28-day survival, patients with CA; multivariable
0.17(0.05–0.58)
Favourable neurological outcome at discharge, patients with CA; multivariable
0.22(0.06–0.81)
Observational data: associations, not effects.
Further findings
28-day survival, neurological outcomes and event-free days (ICU-, ventilator-, catecholamine-free days), patients without CA
- ECMO did not improve 28-day survival or neurological outcomes and decreased event-free days in patients without CA
Safety
Bleeding complications, patients without CA
- ECMO increased frequency of bleeding complications
Original publication
Outcome of extracorporeal membrane oxygenation use in severe accidental hypothermia with cardiac arrest and circulatory instability: A multicentre, prospective, observational study in Japan (ICE-CRASH study). Resuscitation. Published 9 December 2022. doi:10.
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