LAUSR

The impact of mechanical circulatory assist devices (MCS) has not been well studied in cardiac arrest survivors. We examined that association of MCS with risk of mortality among comatose cardiac arrest survivors Compare the survival between different MCS and non MCS groups This is a retrospective cohort study of 1417 comatose adult cardiac arrest survivors that survived for at least 1 day post cardiopulmonary resuscitation. Cox proportional hazard models adjusted for demographics, resuscitation parameters, comorbidities and medications were used to compute hazard ratios for extracorporeal membrane oxygenation (ECMO), ECMO + Impella/intraaortic balloon pump (IABP), IABP and Impella associated with risk of short term 60 day mortality. Kaplan meier's curves were used to demonstrate cumulative survival rate. Among 1417 cardiac arrest survivors, MCS was used among 553 (39.1%) patients. After 60 days of follow up, mortality rate was 49.4% in non MCS group, 58.6% in IABP group, 22.9% in Impella group, 40.0% in ECMO only group, 50.0% in ECMO + Impella/IABP group. When compared with no MCS use, only Impella use was associated with decrease risk of short term mortality (HR 0.37; 95% CI 0.16–0.83, p=0.02) while there was no significant association of other forms of MCS with short term mortality. There was no significant association of any MCS with long term mortality. Kaplan-Meier curves demonstrate early benefit of Impella and very early benefit of ECMO (figure 1). This is the first large study to report various types of MCS use among comatose cardiac arrest survivors and has shown an indication of benefit with Impella use only in first 60 days post cardiac arrest. Future prospective study may be needed to validate this association None