{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:35:50Z","timestamp":1773783350740,"version":"3.50.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>While the immediate goal of cardiopulmonary resuscitation is to achieve return of spontaneous circulation, the patient-centered goal is to minimize neurological injury. Several medications used during cardiac arrest have been associated with poor neurological outcomes. For patients cannulated for veno-arterial extracorporeal membrane oxygenation during cardiac arrest, termed extracorporeal cardiopulmonary resuscitation, the patient-centered impact of these medications has not yet been described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a retrospective Extracorporeal Life Support Organization registry-based analysis. The primary outcome was cerebral performance category (CPC) score at hospital discharge. Cumulative odds models assessed the association between either (1) binary receipt of a medication or (2) the number of epinephrine milligrams given, and CPC score. The model reports the probability of having a score lower than each CPC level. To minimize bias in the receipt of advanced cardiovascular life support drugs, we used inverse probability treatment weights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Antiarrhythmics were associated with better neurological outcomes (amiodarone: CPC \u2264 1 [odds ratio [OR], 1.28 [95% CI, 1.00\u20131.65];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.048] and CPC \u2264 2 [OR, 1.38 [95% CI, 1.06\u20131.78];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.015]; lidocaine: CPC \u2264 1 [OR, 1.69 [95% CI, 1.32\u20132.17];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001], CPC \u2264 2 [OR, 1.82 [95% CI, 1.39\u20132.38];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001], CPC \u2264 3 [OR, 1.76 [95% CI, 1.30\u20132.40];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001]). Intraarrest sodium bicarbonate administration resulted in a lower likelihood of a CPC &lt; 2 to 3 (CPC \u2264 2 [OR, 0.63 [95% CI, 0.49\u20130.81];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001], CPC \u2264 3 [OR, 0.65 [95% CI, 0.49\u20130.86];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.003]). There was no significant difference in CPC score among adults who received intraarrest calcium. The unweighted cumulative effects model demonstrated a dose-dependent increasing relationship between epinephrine doses and harm for all CPC levels (OR, 0.89\u20130.94;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Our data support that increasing doses of epinephrine and nonantiarrhythmic advanced cardiovascular life support medications both worsen the probability of neurologically intact survival for patients who undergo extracorporeal cardiopulmonary resuscitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.013420","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:53:40Z","timestamp":1767830020000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Advanced Cardiac Life Support Medications on Discharge Neurological Function for Survivors of Cardiac Arrest When Using ECPR"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4314-973X","authenticated-orcid":true,"given":"Maxwell A.","family":"Hockstein","sequence":"first","affiliation":[{"name":"Departments of Emergency Medicine and Critical Care Medicine, Georgetown University School of Medicine, MedStar Washington Hospital Center, Washington, DC (M.A.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9915-0591","authenticated-orcid":true,"given":"Nicholas J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle (N.J.J.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua J.","family":"Horns","sequence":"additional","affiliation":[{"name":"Department of Surgery (J.J.H.), University of Utah Health, Salt Lake City."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2343-9521","authenticated-orcid":true,"given":"Scott T.","family":"Youngquist","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (S.T.Y.), University of Utah Health, Salt Lake City."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5132-0958","authenticated-orcid":true,"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, Anesthesiology, and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.-M.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8879-2628","authenticated-orcid":true,"given":"Joseph E.","family":"Tonna","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Departments of Surgery and Emergency Medicine (J.E.T.), University of Utah Health, Salt Lake City."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.227.7.833"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001194"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resplu.2022.100315"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2017.08.008"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806842"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.0795"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2016.07.237"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32338-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.1025"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204511"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002128"},{"key":"e_1_3_3_14_2","unstructured":"RStudio: integrated development environment for R. 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