Refractory IHCA and OHCA Treated With ECMO

Refractory In and Out of Hospital Cardiac Arrest Treated With Extracorporeal Membrane Oxygenation. Observational, Single Centre, Prospective Study.

Extracorporeal membrane oxygenation (ECMO) support has been suggested to improve the survival rate in patients with refractory cardiac arrest (CA). Recent studies have also highlighted the potential early application of this method in improving the prognosis of prolonged cardiac arrest both for in hospital CA (INHCA) and out of hospital CA (OHCA). The rationale for use of ECMO in these patients is to optimize early perfusion of vital organs, curing the cause of CA and waiting for the recovery of the injured myocardium. The investigators have created a flow-chart to decide which patients are eligible. The aims of this study are to evaluate if, with this flow-chart, the investigators are able to detect which patients have more probability of survival.

Inclusion Criteria:

• Adults 18-75 years old
• In and out of hospital Witnessed Cardiac Arrest
• No-flow time < 5 min. or VF,VT,TP as rhythm of presentation
• Low-flow time < 45 min.
• End Tidal CO2 > 10 after 20 min.of CPR

Exclusion Criteria:

• Comorbidities such:
• Terminal Malignancy
• Aortic Dissection
• Severe Cardiac Failure without transplant indication
• Severe Aortic Valve Failure
• Known Severe Peripheral arteriopathy