(A152) Comparison of Load Distributing Band and Standard Cardiopulmonary Resuscitation in Patients Presenting with Cardiac Arrest to Emergency Department

ObjectiveTo compare resuscitation outcomes before and after switching from manual cardiopulmonary resuscitation (CPR) to load-distributing band (LDB) CPR in a multi-center Emergency Departments (ED) trial.MethodsThis is a phased, prospective cohort evaluation with intention-to-treat analysis of adults with non-traumatic cardiac arrest. The intervention is change in the system from manual CPR to LDB-CPR at two Urban EDs. The main outcome measure is survival to hospital discharge, with secondary outcome measures of return of spontaneous circulation (ROSC), survival to hospital admission and neurological outcome at discharge.ResultsA total of 1,011 patients were included in the study, with 459 in the manual CPR phase (January 01, 2004, to August 24, 2007) and 552 patients in the LDB-CPR phase (August 16, 2007, to December 31, 2009). In the LDB phase, the LDB device was applied in 454 patients (82.3%). Patients in the manual CPR and LDB-CPR phases were comparable for mean age, gender and ethnicity. Rates for ROSC were comparable with LDB-CPR (manual 22.4% vs. LDB 35.3%; adjusted odds ratio [OR], 1.07; 95% confidence interval [CI], 0.63-1.83). Survival to hospital admission was increased, Manual 14.2% vs. LDB 19.7%; adjusted OR, 2.50; 95% CI, 1.05-6.00. Survival to hospital discharge was increased Manual 1.3% vs. LDB 3.3%; adjusted OR, 3.99; 95% CI, 1.06-15.02. The number of survivors with Cerebral Performance Category 1 (good) (Manual 1 vs. LDB 12, p < 0.01) and Overall Performance Category 1 (good) (Manual 1 vs. LDB 10, p < 0.01) was also increased. The Number Needed to Treat (NNT) for 1 survivor was 52 (95% CI, 26-1000).ConclusionA resuscitation strategy using LDB-CPR in an ED environment was associated with improved survival to admission and discharge in adults with non-traumatic cardiac arrest.

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Outcome of Conventional Bystander Cardiopulmonary Resuscitation in Cardiac Arrest Following Drowning

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000060 ◽

2020 ◽

Vol 35 (2) ◽

pp. 141-147 ◽

Cited By ~ 1

Author(s):

Joshua M. Tobin ◽

William D. Ramos ◽

Joel Greenshields ◽

Stephanie Dickinson ◽

Joseph W. Rossano ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Hospital Discharge ◽

Age Groups ◽

Cerebral Performance Category ◽

Age Group ◽

Performance Category ◽

Bystander Cardiopulmonary Resuscitation ◽

Group Survival ◽

Bystander Cpr

AbstractIntroduction:The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.Hypothesis/Problem:The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.Methods:The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable survival, as defined by cerebral performance category (CPC).Results:Neurologically favorable survival was statistically significantly associated with CV-CPR in pediatric patients aged five to 15 years (aOR = 2.68; 95% CI, 1.10–6.77; P = .03), as well as all age group survival to hospital discharge (aOR = 1.54; 95% CI, 1.01–2.36; P = .046). There was a trend with CV-CPR toward neurologically favorable survival in all age groups (aOR = 1.35; 95% CI, 0.86–2.10; P = .19) and all age group survival to hospital admission (aOR = 1.29; 95% CI, 0.91–1.84; P = .157).Conclusion:In cases of cardiac arrest following drowning, bystander CV-CPR was statistically significantly associated with neurologically favorable survival in children aged five to 15 years and survival to hospital discharge.

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Abstract 13013: Survival After In-Hospital Cardiopulmonary Resuscitation for Cardiac Arrest in Patients With COVID-19: An Updated Meta-Analysis

Circulation ◽

10.1161/circ.144.suppl_2.13013 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Archana Pattupara ◽

Devika Aggarwal ◽

Kirtipal S Bhatia ◽

Olga Gomez-Rojas ◽

vardhmaan jain ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Discharge ◽

Meta Analysis ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Neurological Recovery ◽

Term Survival ◽

Performance Category ◽

Initial Rhythm ◽

Hospital Cardiac Arrest

Introduction: Several small studies have reported variable outcomes following in-hospital cardiac arrest (IHCA) in patients with COVID-19. A clear estimate is important in prognostication and guiding resuscitation efforts and policies for these patients. Methods: A search of PubMed, Embase, and Scopus databases was conducted to identify studies reporting outcomes after IHCA in adult patients with confirmed COVID-19. The cumulative characteristics of the patients were described. The primary outcome studied was survival at 30 days or at hospital discharge (short term survival). Additional outcomes of interest were proportional prevalence of the initial rhythm at arrest, return of spontaneous circulation (ROSC), and neurological recovery (defined as Cerebral Performance Category Score of 1-2 ). Metanalysis of proportions was performed utilizing the Metaprop command. A random effects model was chosen to account for interstudy variance. Results: A total of 13 eligible studies were identified and included in the analyses. Out of all the hospitalized patients with COVID-19, 1,618 underwent advanced cardiac resuscitation after an IHCA. Patients who had a cardiac arrest had a median age between 50-69 years. IHCA occurred predominantly in men, and in the ICU setting. Shockable rhythms were identified in 8% (95% CI 5-10%, I2; 56%) and non-shockable rhythms in 89% (95% CI 85-94% I2; 84%) of patients (Fig. 1a). ROSC was achieved in 40% (95% CI 31-48% I2; 90%) (Fig. 1b). Only 7 % ( 95% CI 3-12% I2; 86%) of patients survived at 30 days/hospital discharge (Fig. 1c). Neurological recovery was seen in 5% (95% CI 3-9% I2; 67%) of patients who suffered a IHCA (Fig. 1d). Conclusions: Our meta-analysis demonstrates the majority of the cardiac arrests in patients with COVID-19 have non-shockable rhythms. Survival rate in these patients is low, and neurological recovery is unfavorable. This study provides further insight in guiding resuscitation efforts in these patients.

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Success Rate and Predictors of Adult Cardiopulmonary Resuscitation at the Emergency Room in a University Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.05.10411 ◽

2020 ◽

Vol 103 (5) ◽

pp. 481-487

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Hospital Admission ◽

Emergency Room ◽

Hospital Discharge ◽

Adult Patients ◽

University Hospital ◽

Secondary Outcome ◽

Success Rates ◽

Predicting Factors

Objective: To determine the success rates of adult cardiopulmonary resuscitation (CPR) and identify the predictors of successful CPR at the emergency room (ER) at a university-based hospital. Materials and Methods: Adult patients that experienced cardiac arrest and received CPR at the ER were prospectively observed. The primary outcomes were the rates of return of spontaneous circulation (ROSC), survival to hospital admission, survival to hospital discharge, and discharge with good neurological outcome. The secondary outcome was to determine the predictors of ROSC. Results: One hundred twenty-nine adult patients were enrolled in the study. The success rates of CPR were ROSC 41.9%, survived to hospital admission 34.1%, survived to hospital discharge 8.5%, and discharged with a good neurologic outcome 3.9%. From multiple logistic regression, the predicting factors for ROSC were cardiac arrest at the ER (odds ratio [OR] 4.89, 95% CI 1.90 to 12.55; p<0.001) and cardiac arrest during morning shift (OR 2.40, 95% CI 1.08 to 5.34; p=0.031). Conclusion: The success rates of the CPR outcomes were good. Cardiac arrest at the ER and arrest during the daytime were predicting factors for ROSC. Keywords: Adult cardiopulmonary resuscitation, Cardiac arrest, Emergency room

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Abstract 204: Conventional vs. Compression-Only Cardiopulmonary Resuscitation for Geriatric Out-of-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.138.suppl_2.204 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Hiroki Ueyama ◽

Yosuke Homma ◽

Hiroyasu Shimizu ◽

Tetsuya Inoue ◽

Hiraku Funakoshi

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Scale Score ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Category Scale ◽

Performance Category ◽

Adjusted Analysis ◽

Significant Difference ◽

Hospital Cardiac Arrest

Introduction: Compression-only cardiopulmonary resuscitation (CPR) and conventional CPR (30:2, chest compression and rescue breathing) performed by bystanders are known to have similar outcomes in adults. This study aimed to investigate if this difference is applicable in geriatric populations as well. Methods: We conducted a prospective observational study using the All-Japan Utstein Registry to enroll geriatric patients (≥75 years) who experienced out-of-hospital cardiac arrest that was witnessed by bystanders in Japan from January 1, 2009 to December 31, 2013. The primary outcome was favorable neurological function 1 month after the event, which was defined as a Cerebral Performance Category Scale score of 1 or 2. The secondary outcomes were return of spontaneous circulation (ROSC), 1-month survival, and favorable overall function 1 month after the event, which was defined as an Overall Performance Category Scale score of 1 or 2. Outcomes of compression-only CPR and conventional CPR were compared using multivariable logistic regression analyses. Results: Of the 58,072 enrolled patients, 13,248 (22.8%) received conventional CPR whereas 44,824 (77.2%) received compression-only CPR. Favorable neurological outcomes were achieved in 708 (5.3%) patients receiving CPR and 1799 (4.0%) patients receiving compression-only CPR. A crude analysis of neurologically favorable survival revealed superiority of conventional CPR [odds ratio (OR), 1.35; 95% confidence interval (CI), 1.24–1.48; P < 0.001]], but it was no longer statistically significant after multivariable adjustment (OR, 1.09; 95% CI, 0.93–1.27; P = 0.29). Similarly, multivariable adjusted analysis of favorable overall function survival showed no significant difference (OR, 1.08; 95% CI, 0.92–1.26; P = 0.38) between conventional and compression-only CPR. Conventional CPR demonstrated better outcomes in multivariable adjusted analysis of ROSC and 1 month survival (OR, 1.30; 95% CI, 1.22–1.40; P < 0.001 and OR, 1.13. 95% CI, 1.04–1.23; P = 0.003, respectively). Conclusions: The superiority of conventional CPR in geriatric populations was not proven. Thus, we conclude that compression-only CPR is an adequate means of resuscitation in geriatric populations.

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Impact of the cardiopulmonary resuscitation-related injuries on the prognosis after cardiac arrest

European Heart Journal ◽

10.1093/ehjci/ehaa946.1819 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Merino Argos ◽

I Marco Clement ◽

S.O Rosillo Rodriguez ◽

L Martin Polo ◽

E Arbas Redondo ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Cerebral Performance Category ◽

University Hospital ◽

Temperature Management ◽

Performance Category ◽

Neurological Outcomes ◽

Cardiac Care Unit ◽

Sternal Fractures

Abstract Background Cardiopulmonary resuscitation (CPR) manoeuvres involve vigorous compressions with the proper depth and rate in order to keep sufficient perfusion to organs, especially the brain. Accordingly, high incidences of CPR-related injuries (CPR-RI) have been observed in survivors after cardiac arrest (CA). Purpose To analyse whether CPR-related injuries have an impact on the survival and neurological outcomes of comatose survivors after CA. Methods Observational prospective database of consecutive patients (pts) admitted to the acute cardiac care unit of a tertiary university hospital after in-hospital and out-of-hospital CA (IHCA and OHCA) treated with targeted temperature management (TTM 32–34°) from August 2006 to December 2019. CPR-RI were diagnosed by reviewing medical records and analysing image studies during hospitalization. Results A total of 498 pts were included; mean age was 62.7±14.5 years and 393 (78.9%) were men. We found a total of 145 CPR-RI in 109 (21.9%) pts: 79 rib fractures, 20 sternal fractures, 5 hepatic, 5 gastrointestinal, 3 spleen, 1 kidney, 26 lung and 6 heart injuries. Demographic characteristics and cardiovascular risk factors did not differ between the non-CPR-RI group and CPR-RI group. Also, we did not find differences in CA features (Table 1). Survival at discharge was higher in the CPR-RI group [74 (67.8%) vs 188 (48.3%); p<0.001]. Moreover, Cerebral Performance Category (CPC) 1–2 within a 3-month follow-up was significantly higher in the CPR-RI group [(71 (65.1%) vs 168 (43.2%); p<0.001; Figure 1]. Finally, pts who recieved blood transfusions were proportionally higher in the CPR-RI group [34 (32.1%) vs 65 (16.7%)]; p=0.004). Conclusions In our cohort, the presence of CPR-RI was associated with higher survival at discharge and better neurological outcomes during follow-up. Figure 1 Funding Acknowledgement Type of funding source: None

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The Success Rate of Pediatric In-Hospital Cardiopulmonary Resuscitation in Ahvaz Training Hospitals

Scientifica ◽

10.1155/2016/9648140 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Shideh Assar ◽

Mohsen Husseinzadeh ◽

Abdul Hussein Nikravesh ◽

Hannaneh Davoodzadeh

Keyword(s):

Cardiopulmonary Resuscitation ◽

Neurological Outcome ◽

Survival Rates ◽

Cerebral Performance Category ◽

Developed Countries ◽

Spontaneous Circulation ◽

Secondary Outcome ◽

Drug Infusion ◽

Factors Influencing ◽

Favorable Neurological Outcome

Research Objective. This study determined the outcome of cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest and factors influencing it in two training hospitals in Ahvaz.Method. Patients hospitalized in the pediatric wards and exposed to CPR during hospital stay were included in the study (September 2013 to May 2014). The primary outcome of CPR was assumed to be the return of spontaneous circulation (ROSC) and the secondary outcome was assumed to be survival to discharge. The neurological outcome of survivors was assessed using the Pediatric Cerebral Performance Category (PCPC) method.Results. Of the 279 study participants, 138 patients (49.4%) showed ROSC, 81 patients (29%) survived for 24 hours after the CPR, and 33 patients (11.8%) survived to discharge. Of the surviving patients, 16 (48.5%) had favorable neurological outcome. The resuscitation during holidays resulted in fewer ROSC. Multivariate analysis showed that longer CPR duration, CPR by junior residents, growth deficiency, and prearrest vasoactive drug infusion were associated with decreased survival to discharge (p<0.05). Infants and patients with respiratory disease had higher survival rates.Conclusion. The rate of successful CPR in our study was lower than rates reported by developed countries. However, factors influencing the outcome of CPR were similar. These results reflect the necessity of paying more attention to pediatric CPR training, postresuscitation conditions, and expansion of intensive care facilities.

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How many prehospital defibrillation attempts should be performed in out-of-hospital cardiac arrest patients with shockable rhythm?

10.21203/rs.3.rs-106512/v1 ◽

2020 ◽

Author(s):

Byuk Sung Ko ◽

Youn-Jung Kim ◽

Kap Su Han ◽

You Hwan Jo ◽

Jonghwan Shin ◽

...

Keyword(s):

Cardiac Arrest ◽

Odds Ratio ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Neurologic Outcome ◽

Secondary Outcome ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Shockable Rhythm ◽

Good Neurologic Outcome ◽

Hospital Cardiac Arrest

Abstract Background: Early defibrillation is vital to improve outcomes after out-of-hospital cardiac arrest (OHCA) with shockable rhythm. Currently, there is no agreed consensus on the number of defibrillation attempts before transfer to a hospital. This study aimed to evaluate the correlation between the number of defibrillations on the prehospital return of spontaneous circulation (ROSC).Methods: A multicenter, prospective, observational registry-based study was conducted for OHCA in patients with presumed cardiac etiology that underwent prehospital defibrillation between October 2015 and June 2017. The primary outcome was prehospital ROSC, and the secondary outcome was a good neurologic outcome at hospital discharge, defined as Cerebral Performance Category score 1 or 2. Results: Among 2,155 OHCA patients’ data, 178 patients with missing data were excluded, a total of 1,983 OHCA patients who received prehospital defibrillation were included. The median age was 61 years and prehospital ROSC was observed in 738 patients (37.2%). The median time from arrest to first defibrillation was 10 (interquartile range: 7-15) minutes. The cumulative ROSC rates and good neurologic outcome from the initial defibrillation to the sixth defibrillation were 43%, 68%, 81%, 90%, 95%, 98% and 42%, 66%, 81%, 90%, 95%, 98%, respectively. After clinical characteristics adjustment and time to defibrillation, the number of defibrillations were independently associated with ROSC (odds ratio 0.81 95% CI 0.76-0.86) and good neurologic outcome (odds ratio 0.86 95% CI 0.80-0.91). Moreover, subgroup analysis results with patients that underwent the initial defibrillation within 10 minutes from arrest were consistent (95% up to five times).Conclusion: More than 95% of prehospital ROSC was achieved within five times of defibrillation in OHCA patients. This result provides a basis for the ideal number of defibrillation attempts before transfer to hospital with the possibility of extracorporeal cardiopulmonary resuscitation in these refractory ventricular fibrillation patients.

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Utility of opening rhythms in predicting time to return of spontaneous circulation in cardiac arrest victims in a resource constrained setting: a single centre prospective observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195543 ◽

2019 ◽

Vol 7 (12) ◽

pp. 4709

Author(s):

Appu Suseel ◽

Siju V. Abraham ◽

Radha K. R.

Keyword(s):

Cardiac Arrest ◽

Hospital Discharge ◽

Cardiopulmonary Arrest ◽

Spontaneous Circulation ◽

Secondary Outcome ◽

Resource Constrained ◽

Return Of Spontaneous Circulation ◽

Shockable Rhythm ◽

Significant Difference ◽

Mean Time

Background: Time to ROSC has been shown to be an important and independent predictor of mortality and adverse neurological outcome. In resource limited situations judicious deployment of resources is crucial. Prognostication of arrest victims may aid in better resource allocation. This study aimed to assess the time to Return of Spontaneous Circulation (ROSC) in cardiac arrest victims and its relationship with opening rhythms.Methods: Consecutive victims of cardiopulmonary arrest who presented to a single center were included in this study if they met the inclusion and exclusion criteria. Time at which opening rhythm was analyzed and time at which ROSC was achieved was noted. This was done for all cases and mean time to ROSC was calculated for each opening rhythm. All those patients who achieved ROSC were followed up till hospital discharge or death. Primary outcome measured was achievement of ROSC and the secondary outcome was the survival to hospital discharge.Results: A sample size of 100 was calculated to yield a significance criterion of 0.05 and a power of 0.80 based on prior studies. Out of 100 patients studied. 58% had shockable rhythms and 42% had non-shockable rhythms. Mean time to ROSC for shockable rhythm was 5.55±3.51 minutes, and for non-shockable rhythm is 17.29±4.18 minutes. There was a statistically significant difference between opening rhythms in terms of survival to hospital discharge (p=0.0329).Conclusions: Cardiac arrests with shockable rhythms attained ROSC faster when compared to nonshockable rhythms. Shockable rhythms have a better survival to hospital discharge when compared to shockable rhythms. Opening rhythms may aid the clinician in better utility of resources in a resource constrained setting.

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The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10235573 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5573

Author(s):

Karol Bielski ◽

Agnieszka Szarpak ◽

Miłosz Jaroslaw Jaguszewski ◽

Tomasz Kopiec ◽

Jacek Smereka ◽

...

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Hospital Discharge ◽

Meta Analysis ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Survival Outcomes ◽

Cochrane Central Register ◽

Mortality And Morbidity ◽

Hospital Cardiac Arrest

Cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Because the COVID-19 pandemic may have impacted mortality and morbidity, both on an individual level and the health care system as a whole, our purpose was to determine rates of OHCA survival since the onset of the SARS-CoV2 pandemic. We conducted a systematic review and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes according to the PRISMA guidelines. We searched the literature using PubMed, Scopus, Web of Science and Cochrane Central Register for Controlled Trials databases from inception to September 2021 and identified 1775 potentially relevant studies, of which thirty-one articles totaling 88,188 patients were included in this meta-analysis. Prehospital return of spontaneous circulation (ROSC) in pre-COVID-19 and COVID-19 periods was 12.3% vs. 8.9%, respectively (OR = 1.40; 95%CI: 1.06–1.87; p < 0.001). Survival to hospital discharge in pre- vs. intra-COVID-19 periods was 11.5% vs. 8.2% (OR = 1.57; 95%CI: 1.37–1.79; p < 0.001). A similar dependency was observed in the case of survival to hospital discharge with the Cerebral Performance Category (CPC) 1–2 (6.7% vs. 4.0%; OR = 1.71; 95%CI: 1.35–2.15; p < 0.001), as well as in the 30-day survival rate (9.2% vs. 6.4%; OR = 1.63; 95%CI: 1.13–2.36; p = 0.009). In conclusion, prognosis of OHCA is usually poor and even worse during COVID-19.

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Out-of-hospital cardiac arrest patients with an initial non-shockable rhythm could be candidates for extracorporeal cardiopulmonary resuscitation: a retrospective study.

10.21203/rs.3.rs-31150/v1 ◽

2020 ◽

Author(s):

Atsunori Tanimoto ◽

Kazuhiro Sugiyama ◽

Maki Tanabe ◽

Kanta Kitagawa ◽

Ayumi Kawakami ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Hospital Discharge ◽

Cerebral Performance Category ◽

Low Flow ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Emergency Medical Service Personnel ◽

Good Outcome ◽

Shockable Rhythm ◽

Hospital Cardiac Arrest

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory out-of-hospital cardiac arrest (OHCA). Most studies evaluating the effectiveness of ECPR include patients with an initial shockable rhythm. However, the effectiveness of ECPR for patients with an initial non-shockable rhythm remains unknown. This retrospective single-center study aimed to evaluate the effectiveness of ECPR for patients with an initial non-shockable rhythm, with reference to the outcomes of OHCA patients with an initial shockable rhythm. Methods Adult OHCA patients treated with ECPR at our center during 2011–2018 were included in the study. Patients were classified into the initial shockable rhythm group and the non-shockable rhythm group. The primary outcome was the cerebral performance category (CPC) scale score at hospital discharge. A CPC score of 1 or 2 was defined as a good outcome. Results In total, 186 patients were eligible. Among them, 124 had an initial shockable rhythm and 62 had an initial non-shockable rhythm. Among all patients, 158 (85%) were male, with a median age of 59 (interquartile range [IQR], 48–65) years, and the median low flow time was 41 (IQR, 33–48) min. Collapse was witnessed in 169 (91%) patients, and 36 (19%) achieved return of spontaneous circulation (ROSC) transiently. Proportion of female patients, presence of bystander cardiopulmonary resuscitation, and collapse after the arrival of emergency medical service personnel were significantly higher in the non-shockable rhythm group. The rate of good outcomes at hospital discharge was not significantly different between the shockable and non-shockable groups (19% vs. 16%, p=0.69). Initial shockable rhythm was not significantly associated with good outcome after controlling for potential confounders (adjusted odds ratio 1.58, 95% confidence interval: 0.66–3.81, p=0.31). In the non-shockable group, patients with good outcomes had a higher rate of transient ROSC, and pulmonary embolism was the leading etiology. Conclusions The outcomes of patients with an initial non-shockable rhythm are comparable with those having an initial shockable rhythm. OHCA patients with an initial non-shockable rhythm could be candidates for ECPR, if they are presumed to have reversible etiology and potential for good neurological recovery.

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