Podcast 678: ECMO for Refractory VFib

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

• Refractory ventricular fibrillation, defined as 3 defibrillation shocks without resolution, was studied via RCT looking to compare ECMO with cardiac cath vs. typical resuscitation
• After 30 patients (15 each arm), the trial was stopped because such a significant benefit seen in the ECMO arm
• 6 patients survived and 3 had good neurological outcomes at 6 months with ECMO
• This is compared to 1 patient surviving initially and none surviving at 6 months in the typical resuscitation arm

References

Yannopoulos D, Bartos J, Raveendran G, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Lancet. 2020;396(10265):1807-1816. doi:10.1016/S0140-6736(20)32338-2

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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