68: ARREST – The First Randomized ECPR Trial Ever

 

 

 

 

 

 

The ARREST Trial is published!  Demetris Yannopoulos, Jason Bartos and their army of rockstars have done it!  This is the first randomized ECPR trial and it showed tremendous benefit of ECPR compared to traditional therapies.  Zack explores this paper and their concurrent publication of process with Demetris.   Their two Lancet papers are below

  • https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32338-2/fulltext
  • https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30376-X/fulltext

In the news, Jenelle Badulak and her crew at UW saved a hypothermic mountaineer in Seattle.  Story here.

  • https://www.bbc.com/news/world-us-canada-54959874

Demetri Yannopoulos     Photo of Jason A Bartos

Demetris Yannopoulos and Jason Bartos

 

EDECMO 36 – Crushing the Nihilism of Cardiac Arrest – with Demetris Yannopoulos

…all acute injury to the heart is reversible.

 

Demetris Yannapoulos
University of Minnesota

In this podcast episode, Zack interviews Demetris Yannopoulos from the University of Minnesota. Demetris has organized Minneapolis into arguably the most impressive ECPR city in the world. He has changed the mindset of out of hospital refractory ventricular fibrillation care from “stay and play”, the philosophy that medics should stay at the scene and provide care until ROSC (return of spontaneous circulation) or until the patient is pronounced dead. In Minneapolis, a patient who who arrests in  Yannopoulos’ catchment area gets three shocks. If the patient does not get ROSC then they are immediately transported to the University of Minnesota using LUCAS mechanical chest compression device. The patient bypasses the emergency department and goes directly to the cath lab. In the cath lab, Demetris, or one of his partners, cannulates and initiates ECMO with an average time of 6 minutes!!! In his first 90 patients he has had a 45% neurologically intact survivorship. Patients are getting to the cath lab on average 60 minutes after their arrest. In this cohort, you would expect a less than 1% survival. We can use Dr. Yannopoulos’ model to expand the use of ECPR in many other systems. The real question is do we have champions like Demetris who will rise to the calling!