Prognostic factors for out-of-hospital cardiac arrest patients with prolonged low-flow time undergoing extracorporeal cardiopulmonary resuscitation.

IF 4.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Kasumi Shirasaki, Masaki Okajima, Tasuku Hada, Shutaro Isokawa, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Tadashi Toyama, Toru Hifumi, Norio Otani
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引用次数: 0

Abstract

Background: This study aimed to examine factors associated with favourable neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients with low-flow time (LFT) exceeding 60 minutes following extracorporeal cardiopulmonary resuscitation (ECPR).

Methods: This was a secondary analysis of the SAVE-J II study, a retrospective, multicentre, registry study involving 36 participating institutions in Japan. OHCA patients ≥18 years old who underwent ECPR in Japan between January, 2013 and December, 2018 were registered. This study selected the non-hypothermic patients with LFT ≥ 60 minutes. The primary outcome was a favourable neurological outcome (cerebral performance categories 1-2). Multivariable logistic regression analyses were performed to assess the factors associated with a favourable neurological outcome.

Results: In total, 708 patients met the inclusion criteria, with favourable neurological outcomes at hospital discharge in 71 cases (10.0%). Age, shockable rhythm on hospital arrival, signs of life (SOLs) on hospital arrival, and transient return of spontaneous circulation (ROSC) were significantly associated with a favourable neurological outcome.

Conclusions: Approximately 10% of OHCA patients who underwent ECPR with LFT ≥ 60 minutes had favourable neurological outcomes. ECPR for non-hypothermic OHCA patients might be considered even with prolonged LFT based on age, shockable rhythm on hospital arrival, SOLs on hospital arrival, and presence of transient ROSC before ECMO initiation.

院外心脏骤停患者低流量时间延长接受体外心肺复苏的预后因素。
背景:本研究旨在探讨院外心脏骤停(OHCA)患者体外心肺复苏(ECPR)后低流量时间(LFT)超过60分钟的神经系统预后的相关因素。方法:这是对SAVE-J II研究的二次分析,这是一项涉及日本36个参与机构的回顾性、多中心、登记研究。登记2013年1月至2018年12月在日本接受ECPR的≥18岁OHCA患者。本研究选择LFT≥60分钟的非低温患者。主要结果是良好的神经学结果(脑功能分类1-2)。进行多变量逻辑回归分析以评估与良好神经预后相关的因素。结果:708例患者符合纳入标准,71例(10.0%)患者出院时神经系统预后良好。年龄、到达医院时的休克节律、到达医院时的生命体征(SOLs)和短暂的自然循环恢复(ROSC)与良好的神经预后显著相关。结论:大约10%接受ECPR且LFT≥60分钟的OHCA患者有良好的神经预后。基于年龄、到达医院时的休克节律、到达医院时的SOLs以及开始ECMO前是否存在短暂性ROSC,即使LFT延长,也可以考虑对非低温OHCA患者进行ECPR。
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来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
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