(159) Neurologic Outcomes and Quality of Life in Post-Cardiac Arrest Patients With RSC Supported by ECMO

Introduction: Cardiac arrest with return of spontaneous circulation (RCE) presents significant challenges in patient management. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential rescue strategy for refractory shock post-resuscitation. This case series aims to assess neurological outcomes and quality of life in post-cardiac arrest patients supported by ECMO.

Methods: A retrospective case series was conducted on 32 patients who received ECMO support after RCE due to refractory shock. Nine patients received ECMO V-V support, and 21 patients received ECMO V-A support. Neurological outcomes and quality of life were assessed at 6 months after discharge using the Cerebral Performance Categories Score (CPC), Barthel Index, and modified Rankin Scale. Additionally, the SF-12 survey was administered to evaluate the impact on quality of life.

Results: 32 patients experienced cardiac arrest with return of spontaneous circulation before cannulation. The average age was 41 years, with the main causes of cardiac arrest being acute coronary syndrome (46.8%), pulmonary thromboembolism (21.88%), and hypoxemia (18.7%). The most common arrest rhythm was asystole (37.5%), followed by ventricular fibrillation (34.4%). The mean SOFA score was 7 points (IQR 6.5-9), APACHE II score was 12 (IQR 9-16), RESP score was -1 (IQR -1 to -4) in cases of respiratory ECMO, and SAVE score was -3 (IQR -5 to 2) in cases of cardiac ECMO. Overall survival was 71%, and at 6 months, the Barthel score was 75 points, modified Rankin score was 2, Cerebral Performance Categories score was 1, and the SF-12 had an average score of 30. There were no significant associations between time, cause, or rhythm of cardiac arrest and neurological outcomes.

Conclusions: ECMO support in post-cardiac arrest patients with RCE shows promising outcomes in terms of survival and neurological recovery. However, the impact on quality of life, particularly in the emotional and psychosocial domains. Larger-scale studies and prospective designs are needed to validate and expand upon these findings.