Abstract 131: Cardiac Arrest Due to Cardiac Etiology: A Progress Report on the Past 20 Years in an Emergency Department in Vienna

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Patrick Sulzgruber ◽  
Pia Hubner ◽  
Andreas Schober ◽  
Alexander Spiel ◽  
Thomas Uray ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Mortality Rates ◽  
Western World ◽  
The Past ◽  
Initial Event ◽  
Long Term Study ◽  
Number Of Patients ◽  
Favorable Neurological Outcome

Background: Based on demographic changes in the western world, the number of patients with cardiac arrest due to a cardiovascular event is continuously rising. A large variety of factors impacting on favorable neurological outcome (CPC 1-2) and the 6-month survival, are well established. The question whether the knowledge about these predictive factors result in improved outcome over the last 20 years, has not been proven within a long-term study so far. Methods: We prospectively identified 2670 patients (out-of hospital [OOH], n = 1822; in-hospital [IH], n = 848) with cardiac arrest of cardiac etiology and ventricular fibrillation as a first rhythm treated at our emergency department between January 1992 and December 2012. Chi-square test and Cochran-Mantel-Haenszel test have been used to assess differences in CPC and 6-month survival within the observation-period. Results: Within our total cohort, 2189 patients (82.0%) survived the initial event. After a follow-up period of 6 months, 1007 patients (46%) with ROSC deceased. A favorable CPC (1-2) after 6 months has been detected in 1197 patients (54.7%). Within the last 20 years there was an improvement of favorable neurological outcome (CPC 1-2) (p<0.001) and as well a reduction of 6-month mortality rates (p=0.004). Independently in patients with IH cardiac arrest, 78.5% (n=666) survived the initial event, but the 6-month survival rate (n=381, 57.2%) and the favorable CPC outcome (n=443, 66.5%) were approximately higher. Independently within IH cardiac arrest patients a reduction of 6-month mortality rates (p=0.048) was found. Still there were constantly high rates of favorable neurological outcome (CPC 1-2) after 6 months, but there was no improvement within the past 20 years (p=0.665). Conclusion: We were able to demonstrate, that outcome of patients with cardiac arrest of a cardiac etiology has improved significantly within the last 20 years. This gives the impression, that critical care medicine on a high level for patients with cardiac arrest even in the emergency department could be important for outcome. If such specific cardiac arrest centers merged with emergency departments prove to be valuable for ideal patient care has to be further evaluated in detail.

scholarly journals Outcomes of Early versus Late Endotracheal Intubation in Patients with Initial Non-Shockable Rhythm Cardiopulmonary Arrest in the Emergency Department

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kiattichai Daorattanachai ◽  
Winchana Srivilaithon ◽  
Vitchapon Phakawan ◽  
Intanon Imsuwan
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Airway Management ◽  
Hospital Discharge ◽  
Endotracheal Intubation ◽  
Neurological Outcome ◽  
Independent Effect ◽  
Shockable Rhythm ◽  
Significant Difference ◽  
Favorable Neurological Outcome

Background. Sudden cardiac arrest is a critical condition in the emergency department (ED). Currently, there is no considerable evidence supporting the best time to complete advanced airway management (AAM) with endotracheal intubation in cardiac arrest patients presented with initial non-shockable cardiac rhythm. Objectives. To compare survival to hospital discharge and discharge with favorable neurological outcome between the ED cardiac arrest patients who have received AAM with endotracheal intubation within 2 minutes (early AAM group) and those over 2 minutes (late AAM group) after the start of chest compression in ED. Methods. We conducted a retrospective cohort study involving the ED cardiac arrest patients who presented with initial non-shockable rhythm in ED. Multivariable logistic regression analysis was used to evaluate the independent effect of early AAM on outcomes. The outcomes included the survival to hospital discharge and discharge with favorable neurological outcome. Results. There were 416 eligible participants: 209 in the early AAM group and 207 participants in the late AAM group. The early AAM group showed higher survival to hospital discharge compared with the late AAM group, but no statistically significant difference (adjusted odds ratio (aOR): 1.28, 95% confidence interval (CI): 0.59 -2.76, p = 0.524 ). Discharge with favorable neurological outcome is also higher in the early AAM group (aOR: 1.68, 95% CI, 0.52 -5.45, p = 0.387 ). Conclusion. This study did not demonstrate a significant improvement of survival to hospital discharge and discharge with favorable neurological outcome in the ED cardiac arrest patients with initial non-shockable cardiac arrest who underwent early AAM within two minutes. More research is needed on the timing of AAM and on airway management strategies to improve survival.

scholarly journals Improved Early Postresuscitation EEG Activity for Animals Treated with Hypothermia Predicted 96 hr Neurological Outcome and Survival in a Rat Model of Cardiac Arrest

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Bihua Chen ◽  
Feng-Qing Song ◽  
Lei-Lei Sun ◽  
Ling-Yan Lei ◽  
Wei-Ni Gan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Rat Model ◽  
Neurological Outcome ◽  
Cardiac Pacing ◽  
Aortic Pressure ◽  
Sprague Dawley ◽  
Burst Frequency ◽  
Eeg Activity ◽  
Favorable Neurological Outcome ◽  
Hypothermic Group

Purpose.To investigate the effect of hypothermia on 96 hr neurological outcome and survival by quantitatively characterizing early postresuscitation EEG in a rat model of cardiac arrest.Materials and Methods.In twenty male Sprague-Dawley rats, cardiac arrest was induced through high frequency transesophageal cardiac pacing. Cardiopulmonary resuscitation was initiated after 5 mins untreated arrest. Immediately after resuscitation, animals were randomized to either 2 hrs of hypothermia (N=10) or normothermia (N=10). EEG, ECG, aortic pressure, and core temperature were continuously recorded for 6 hrs. Neurological outcome was evaluated daily during the 96 hrs postresuscitation period.Results.No differences in the baseline measurements and resuscitation outcome were observed between groups. However, 96 hr neurological deficit score (204 ± 255 versus 500 ± 0,P=0.005) and survival (6/10 versus 0/10,P=0.011) were significantly better in the hypothermic group. Quantitative analysis of early postresuscitation EEG revealed that burst frequency and spectrum entropy were greatly improved in the hypothermic group and correlated with 96 hr neurological outcome and survival.Conclusion.The improved burst frequency during burst suppression period and preserved spectrum entropy after restoration of continuous background EEG activity for animals treated with hypothermia predicted favorable neurological outcome and survival in this rat model of cardiac arrest.

Abstract 199: Pulmonary Embolism and Accidental Hypothermia Have a Favorable Outcome in Cardiac Arrest With PEA Treated by ECPR

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Shinichi Ijuin ◽  
Akihiko Inoue ◽  
Nobuaki Igarashi ◽  
Shigenari Matsuyama ◽  
Tetsunori Kawase ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Accidental Hypothermia ◽  
Neurological Outcomes ◽  
Good Outcome ◽  
Group B ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Introduction: We have reported previously a favorable neurological outcome by extracorporeal cardiopulmonary resuscitation (ECPR) for out of hospital cardiac arrest. However, effects of ECPR on patients with prolonged pulseless electrical activity (PEA) are unclear. We analyzed etiology of patients with favorable neurological outcomes after ECPR for PEA with witness. Methods: In this single center retrospective study, from January 2007 to May 2018, we identified 68 patients who underwent ECPR for PEA with witness. Of these, 13 patients (19%) had good neurological outcome at 1 month (Glasgow-Pittsburgh Cerebral Performance Category (CPC):1-2, Group G), and 55 patients (81%) had unfavorable neurological outcome (CPC:3-5, Group B). We compared courses of treatment and causes/places of arrests between two groups. Results are expressed as mean ± SD. Results: Patient characteristics were not different between the two groups. Time intervals from collapse to induction of V-A ECMO were also not significantly different (Group G; 46.1 ± 20.2 min vs Group B; 46.8 ± 21.7 min, p=0.92). Ten patients achieved favorable neurological outcome among 39 (26%) with non-cardiac etiology. In cardiac etiology, only 3 of 29 patients (9%) had a good outcome at 1 month (p=0.08). In particular, 5 patients of 10 pulmonary embolism, and 4 of 4 accidental hypothermia responded well to ECPR with a favorable neurological outcome. Additionally, 6 of 13 (46%), who had in hospital cardiac arrest, had good outcome, whereas 7 of 55 (15%) who had out of hospital cardiac arrest, had good outcome (p=0.02). Conclusions: In our small cohort of cardiac arrest patients with pulmonary embolism or accidental hypothermia and PEA with witness, EPCR contributed to favorable neurological outcomes at 1 month.

scholarly journals Association of patient-to-emergency department staff ratio with the incidence of cardiac arrest: A retrospective cohort study

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Cohort Study ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Occupancy Rate ◽  
Number Of Patients ◽  
Ed Overcrowding

Background: Emergency department (ED) overcrowding and overuse are global healthcare problems. Despite that substantial pieces of literature have explored quality parameters to monitor the patients’ safety and quality of care in the ED, to the best of our knowledge, no reasonable patient-to-ED staff ratios were established. Objectives: This study aimed to find the association between unexpected emergency department cardiac arrest (EDCA) and the patient-to-ED staff ratio. Methods: A retrospective cohort study was conducted in a medical center in Taiwan. Non-trauma patients (age > 18) who visited the ED from January 1, 2016 to November 30, 2018 were included. The total number of patients in ED, number of patients waiting for boarding, length of stay over 48 hours, and physician/nurse number in ED were collected and analyzed. The primary outcome was the association of each parameter with the incidence of EDCA. Results: A total of 508 patients were included. The total number of patients in ED ( > 361, RR: 1.54; 95% CI {1.239-1.917}), ED occupancy rate (> 280, RR: 1.54; 95% CI {1.245-1.898}), ED bed occupancy rate (> 184, RR: 1.63; 95% CI {1.308-2.034}), number of patients waiting for boarding (> 134, RR: 1.45; 95% CI {1.164-1.805}), number of patients in ED with length of stay over 48 hours (> 36, RR: 1.27; 95% CI {1.029-1.558}) and patient-to-nurse ratio (> 8.5, adjusted RR: 1.33; 95% CI {1.054-1.672}) had significant associations with higher incidence of EDCA. However, the patient-to-physician ratio was not associated with EDCA incidence. Discussions: Regarding loading parameters, the patient-to-nurse ratio is more representative than the patient-to-physician ratio as regards association with higher EDCA incidence. Conclusions: A higher patient-to-nurse ratio (> 8.5) was associated with an increment in the incidence of EDCA. Our findings provide a basis for setting different thresholds for different ED settings to adjust ED staff and develop individually tailored approaches corresponding to the level of ED overcrowding.

Abstract 588: Extracorporeal Cardiopulmonary Resuscitation for Induction of Hypothermia in Patients with Out-of-Hospital Cardiac Arrest

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ken Nagao ◽  
Kimio Kikushima ◽  
Kazuhiro Watanabe ◽  
Eizo Tachibana ◽  
Takaeo Mukouyama ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Control Group ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hypothermia Group ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Therapeutic hypothermia is beneficial to neurological outcome for comatose survivors after out-of-hospital cardiac arrest. However, there are few data of extracorporeal cardiopulmonary resuscitation (ECPR) for induction of hypothermia for patients with out-of-hospital cardiac arrest. We did a prospective study of ECPR with hypothermia for patients with out-of-hospital cardiac arrest. The criteria for inclusion were an age of 18 to 74 years, a witnessed cardiac arrest, collapse-to-patient’s-side interval <15 minutes, cardiac arrest due to presumed cardiac etiology, and persistent cardiac arrest on ER arrival in spite of the prehospital defibrillations. After arrival at the emergency room, cardiopulmonary bypass plus intra-aortic balloon pumping was immediately performed, and then coronary reperfusion therapy during cardiac arrest was added if needed. Mild hypothermia (34°C for 3 days) was immediately induced during cardiac arrest or after return of spontaneous circulation. We selected suitable patients who received conventional CPR with normothermia among a prospective multi-center observational study of patients who had out-of-hospital cardiac arrest in Kanto region of Japan “the SOS-KANTO study” for the control group. The primary endpoint was favorable neurological outcome at the time of hospital discharge. A total of 558 patients were enrolled; 127 received ECPR with hypothermia and 431 received conventional CPR with normothermia. The ECPR with hypothermia group had significantly higher frequency of the favorable neurological outcome than the conventional CPR with normothermia group (12% vs. 2%, unadjusted odds ratio, 8.1; 95% CI; 3.2 to 20.0). The adjusted odds ratio for the favorable neurological outcome after ECPR with hypothermia was 7.4 (95% CI; 2.8 to 19.3, p<0.0001). Among the ECPR with hypothermia group, early attainment of a target core temperature of 34°C increased its efficacy (adjusted odds ratio, 0.99; 95% CI; 0.98 to 1.00, p=0.04). ECPR with hypothermia improved the chance of neurologically intact survival for adult patients with out-of-hospital cardiac arrest, and the early attainment of a target temperature enhanced its efficacy.

Abstract 246: The Relationship Between Favorable Neurological Outcome in Patients With Out-of-Hospital Cardiac Arrest Due to Cardiac Etiology and Regional Disparity of the Number of Physicians

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Tsukasa Yagi ◽  
Ken Nagao ◽  
Shigemasa Tani ◽  
Eizo Tachibana ◽  
Nobutaka Chiba ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Multivariable Analysis ◽  
Public Health Problem ◽  
Regional Disparity ◽  
Major Public Health Problem ◽  
Favorable Neurological Outcome ◽  
The Relationship ◽  
Hospital Cardiac Arrest

Background: Cardiac arrest is a major public health issue worldwide. In Japan, the regional disparity of the number of physicians per 100000 population is also a major public health problem. However, it is unknown whether there is the relationship between favorable neurological outcome in patients with out-of-hospital cardiac arrest (OHCA) due to cardiac etiology and this regional disparity. The aim of the present study was to clarify this relationship using the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of OHCA. Methods: From the data of the All-Japan Utstein Registry between 2011 and 2015, we included adult patients who had OHCA due to cardiac etiology. 47 prefectures of Japan were divided into quartiles on the basis of the number of physicians in each prefecture, reported by Ministry of Health, Labor and Welfare in Japan. In addition, study patients were divided into four groups based on these quartiles. We compared favorable neurological outcome at 30 days after OHCA in each group, using the multivariable logistic-regression analysis. Results: Four quartile ranges of the number of physicians were set for this study (Figure). Moreover, of the 629,471 OHCA victims between 2011 and 2015, 358,993 met the inclusion criteria. Figure represented favorable neurological outcome at 30 days after OHCA in each quartile. In the multivariable analysis, the adjusted odds ratios for Quartile 2, Quartile 3 and Quartile 4 compared with Quartile 1 for favorable neurological outcome at 30 days after OHCA was 0.971 (95%CI 0.918- 1.027; P=0.307), 1.011 (95%CI 0.956- 1.069; P=0.703) and 0.850 (95%CI 0.809- 0.893; P<0.001), respectively. Conclusion: The regions in which the number of physicians per 100000 population was larger were inferior to the regions in which the number of these was smaller, in terms of neurological benefits in patients with OHCA due to cardiac etiology.

Abstract 12052: A Comprehensive Simulation-Based Training for E-CPR Improves the Neurological Outcome of Patients With Refractory Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Takaaki Toyofuku ◽  
Takashi Unoki ◽  
Junya Matsuura ◽  
Yutaka Konami ◽  
Hiroto Suzuyama ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Training Program ◽  
Neurological Outcome ◽  
Hazard Analysis ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Coronary Syndrome ◽  
Simulation Based ◽  
Favorable Neurological Outcome ◽  
Cpr Training ◽  
Refractory Cardiac Arrest

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) has been utilized as a rescue strategy for patients with refractory cardiac arrest (CA). To improve the outcome of E-CPR, we developed a comprehensive simulation-based E-CPR training program. In the present study we assessed whether the E-CPR training improved the mortality and the neurological outcome. Methods: We have implemented the comprehensive E-CPR simulation training program twice a year to the medical team, which consists of emergency physicians, cardiologists, nurses, clinical engineers, and radiographers using a mock vascular model for E-CPR (ECMO cannulation). We assessed collapse to ECMO time, cumulative 30-day survival and good neurological outcome at hospital discharge defined as the cerebral performance categories (CPC) of 1 or 2. Results: Fifty-three consecutive patients received E-CPR for OHCA from January 2012 to December 2020 in which 31 patients were prior to (until September 2017) and 22 were after (from October 2017) the initiation of the E-CPR training. No differences were found in age, rates of witnessed and bystander-CPR, shockable rhythms, or acute coronary syndrome (ACS). Intra-aortic balloon pump was used in 87% patients prior to and 27% patients after the training (p<0.001), and a microaxial Impella pump was used in 55% after the training. Collapse to ECMO time was significantly shorter after the training (p<0.001). Cumulative 30-day survival and the rate of favorable neurological outcome were significantly higher after the training (p<0.05). Multivariate cox proportional hazard analysis revealed that age (hazard ratio [HR], 1.38 (10 years increase), 95% confidence interval [CI], 1.12-1.73, p=0.002), Collapse to ECMO time (HR, 1.14, 95%CI, 1.04-1.23, p=0.006), and additional Impella use (HR, 0.23, 95% CI, 0.08-0.69, p=0.0009) were significantly associated with the 30-day survival. Conclusions: The E-CPR training significantly improved the collapse to ECMO time. The faster deployment of ECMO improves the neurological outcome and 30-day survival in patients with refractory CA. Additional use of Impella may improve the survival.

Abstract 208: A Comprehensive Simulation-Based Training for E-CPR Improves the Neurological Outcome in Patients With Refractory Out-Of-Hospital Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Takashi Unoki ◽  
Daisuke Takagi ◽  
Yudai Tamura ◽  
Hiroto Suzuyama ◽  
Eiji Taguchi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Intervention Period ◽  
Post Intervention ◽  
Shockable Rhythm ◽  
Time Period ◽  
Simulation Based ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Background: Prolonged conventional cardiopulmonary resuscitation (C-CPR) is associated with a poor prognosis in out-of-hospital cardiac arrest (OHCA) patients. Extracorporeal cardiopulmonary resuscitation (E-CPR) has been utilized as a rescue strategy for patients with cardiac arrest unresponsive to C-CPR. However, the indication and optimal duration to switch from C-CPR to E-CPR are not well established. In addition, the opportunities to develop teamwork skills and expertise to mitigate risks are few. We thus developed the implementation protocol for the E-CPR simulation program, and investigated whether the faster deployment of extracorporeal membrane oxygenation (ECMO) improves the neurological outcome in patients with refractory OHCA. Methods: A total of 42 consecutive patients (age 58±16 years, male ratio 90%, and initial shockable rhythm 64%) received E-CPR (3% of OHCA) during the study period. Among them, 32 (76%) were deployed ECMO during the pre-intervention time period (Pre: from January 2012 to September 2017), whereas 10 (24%) were deployed during the post-intervention time period (Post: October 2017 to May 2019). We compared the door to E-CPR time, collapse to E-CPR time, 30-day mortality, and favorable neurological outcome (Cerebral Performance Categories 1, 2) between the two periods. Results: There was no significant difference in age, the rates of male sex and shockable rhythm, and the time form collapse to emergency room admission between the two periods. The door to E-CPR time and the collapse to E-CPR time were significantly shorter in the post-intervention period compared to the pre-intervention period (Pre: 39 min [IQR; 30-50] vs. Post: 29 min [IQR; 22-31]; P=0.007, Pre: 76 min [IQR; 58-87] vs. Post: 59 min [IQR; 44-68]; P=0.02, respectively). The 30-day mortality was similar between the two periods (Pre: 88% vs. Post: 80%; P=0.6). In contrast, the rate of favorable neurological outcome at the time of discharge was significantly higher in post-intervention period (Pre: 0% vs. Post: 20%; P=0.01) compared to the pre-intervention period. Conclusion: A comprehensive simulation-based training for E-CPR seems to improve the neurological outcome in patients with refractory OHCA patients.

Abstract 165: Impact of Prehospital Epinephrine for Patients Treated With Extracorporeal Cardiopulmonary Resuscitation After Refractory Out-Of-Hospital Shockable Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Ken Nagao ◽  
Yoshio Tahara ◽  
Hiroshi Nonogi ◽  
Naohiro Yonemoto ◽  
David Gaieski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Standard Dose ◽  
Rescue Therapy ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Arrival ◽  
Curve Estimation ◽  
Favorable Neurological Outcome ◽  
Neurologically Intact

Background: The 2015 CoSTR recommended that standard-dose epinephrine (SDE) was reasonable for patients with out-of-hospital cardiac arrest (OHCA) and extracorporeal cardiopulmonary resuscitation (ECPR) was reasonable rescue therapy for selected patients with ongoing cardiac arrest when initial conventional CPR was unsuccessful. We investigated the effect of prehospital SDE for patients who met the criteria of ECPR. Methods: From the All-Japan OHCA Utstein Registry between 2007 and 2015, we included 22,552 patients who met the criteria of ECPR of the SAVE-J study (age between 20 and 75, witnessed shockable OHCA, cardiac arrest on hospital arrival, cardiac etiology, and collapse-to-ECPR interval within 60 minutes). Study patients were divided into two groups according to prehospital SDE or not. Primary endpoint was favorable 30-day neurological outcome after OHCA. Results: Of the 22,552 study patients, 5,659 (25%) received prehospital SDE and 16,893 (75%) did not. The SDE group resulted in lower proportion of favorable 30-day neurological outcome than the no-SDE group (5.6% versus 8.4%, p<0.001) with longer collapse-to-hospital-arrival interval (36.7±9.8 min vs. 29.6±11.3 min, p<0.001). After adjustment for independent predictors of resuscitation, prehospital SDE did not impact on neurological benifit (adjusted OR,1.13; 95%CI,0.98-1.29), but the collapse-to-hospital-arrival interval was associated with neurological benefit (adjusted OR, 0.94; 95% CI, 0.93-0.95). In curve estimation of the SDE group, when collapse-to-hospital-arrival interval was delayed, proportion of the favorable neurological outcome decreased to about 25% at 1 minute and about 0% at 54 minutes (R=0.14). In the 274 patients undergoing ECPR of the SAVE-J study, however, it was about 43% at 1 minute and about 0% at 96 minutes (R=0.17). Conclusions: Prehospital SDE did not improve likelihood of favorable neurological outcome for patients who met the criteria of ECPR (age between 20 and 75, witnessed shockable OHCA, cardiac arrest on hospital arrival, cardiac etiology and collapse-to-ECPR interval within 60 minutes), because SED administration delayed the collapse-to-hospital-arrival interval which was closely related to the neurologically intact survival on ECPR.

Sign in / Sign up

Export Citation Format

Share Document