1. Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan
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Akihiko Inoue, Toru Hifumi, Tetsuya Sakamoto, Hiroshi Okamoto, Jun Kunikata, Hideto Yokoi, Hirotaka Sawano, Yuko Egawa, Shunichi Kato, Kazuhiro Sugiyama, Naofumi Bunya, Takehiko Kasai, Shinichi Ijuin, Shinichi Nakayama, Jun Kanda, Seiya Kanou, Toru Takiguchi, Shoji Yokobori, Hiroaki Takada, Kazushige Inoue, Ichiro Takeuchi, Hiroshi Honzawa, Makoto Kobayashi, Tomohiro Hamagami, Wataru Takayama, Yasuhiro Otomo, Kunihiko Maekawa, Takafumi Shimizu, Satoshi Nara, Michitaka Nasu, Kuniko Takahashi, Yoshihiro Hagiwara, Shigeki Kushimoto, Reo Fukuda, Takayuki Ogura, Shin-ichiro Shiraishi, Ryosuke Zushi, Norio Otani, Migaku Kikuchi, Kazuhiro Watanabe, Takuo Nakagami, Tomohisa Shoko, Nobuya Kitamura, Takayuki Otani, Yoshinori Matsuoka, Makoto Aoki, Masaaki Sakuraya, Hideki Arimoto, Koichiro Homma, Hiromichi Naito, Shunichiro Nakao, Tomoya Okazaki, Yoshio Tahara, Yasuhiro Kuroda, and the SAVE-J II study group
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Real-world data ,Extracorporeal cardiopulmonary resuscitation ,Out-of-hospital cardiac arrest ,Neurological outcome ,Survival rate ,Complication ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.
- Published
- 2022
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