Dobutamine Use in Patients With Extracorporeal Cardiopulmonary Resuscitation Following Out-of-Hospital Cardiac Arrest: A Secondary Analysis of the SAVE-J II Study.

Abstract

Background: The effects of dobutamine on outcomes in patients experiencing out-of-hospital cardiac arrest (OHCA), treated with extracorporeal cardiopulmonary resuscitation (ECPR), remain unclear. In this study, we aimed to evaluate the association between dobutamine use within 24 h and clinical outcomes in patients with OHCA who underwent ECPR.

Methods: A post hoc analysis was conducted on the registry data from the SAVE-J II study (2013-2018). To address potential confounding variables related to dobutamine administration, 1:3 propensity score matching was employed using the patients' baseline characteristics. Following the matching, the dobutamine and non-dobutamine groups were compared, focusing on in-hospital mortality and neurological outcomes assessed using the cerebral performance category (CPC) scale.

Results: Of the 2157 registered cases, 581 cases of cardiogenic OHCA treated with targeted temperature management were included in this analysis. Eighty-eight patients who received dobutamine were compared with 264 who did not after propensity score matching. The in-hospital mortality rate was 60.2% in the dobutamine group, compared with 58.3% in the non-dobutamine group (p = 0.80). The proportion of patients with a CPC score of 3-5 at hospital discharge was 79.5% in the dobutamine group, compared with 78.0% in the non-dobutamine group (p = 0.88). A Kaplan-Meier analysis demonstrated no significant differences in survival rates between the two groups (42.1 vs. 43.6%, log-rank p = 0.79).

Conclusion: In patients with OHCA who underwent ECPR, dobutamine administration within 24 h was not significantly associated with in-hospital mortality and neurological outcomes.