{"title":"Prognostic factors for out-of-hospital cardiac arrest patients with prolonged low-flow time undergoing extracorporeal cardiopulmonary resuscitation.","authors":"Kasumi Shirasaki, Masaki Okajima, Tasuku Hada, Shutaro Isokawa, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Tadashi Toyama, Toru Hifumi, Norio Otani","doi":"10.1093/ehjacc/zuaf072","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Acute Cardiovascular Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjacc/zuaf072","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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.
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.