Cath Lab, Komo, Europe discussed on Cardionerds
America nine percent in Europe. There's a mortality benefit for immediate corner geography and especially in this case with a semi prior to arrest. But as we've been talking about if the patients in refractory cardiac arrest, how am I going to get them to the Cath lab and that's where he CPR comes in so e CPR is extra corporeal CPR or the use of at Komo during refractory cardiac arrest and typically employed when conventional resuscitate efforts have failed. The idea here is to restore circulation as a bridge to diagnosis and treatment. There's a potential in using it to minimize a reverse organ damage and what we're thinking of mostly as the brain network action and prevent rearrest by limiting scheme ya that would trigger ongoing mile cardiac dysfunction. So to date the evidence for easy PR and out of hospital cardiac arrest or mostly from small single centered studies, there's a systematic review in resuscitation in two thousand sixteen and they summarized those single center studies and looked at eight hundred, thirty, three arrests across twenty studies, and they found that CPR was associated with a thirteen percent survival with good neurologic outcome. But all of these studies have very heterogeneous populations different interventions inconsistent follow up the. Evidence there is interesting in nominally seems better than the typically reported survival rates. There's more to investigate here. This is all amazing and the utility of in the acute shock resuscitation setting is so vital and really requires that whole armaments embed neal was talking about. So there's a lot of interesting evidence coming out in recent years about using e CPR for out of hospital cardiac arrest. There's a European registry of greater than thirteen thousand out of hospital cardiac arrest. This is from Paris and they didn't demonstrate actually that there was a dramatically improve survival with CPR versus conventional CPR and this kind of threw everyone for a loop because it's a Little counter to the data that people were seeing from before they ended up finding that survival in their cohort was around eight percent in both groups, and there was really no difference in neuro.