Jeong Ho Park1, Kyoung Jun Song2, Sang Do Shin1, Young Sun Ro3, Ki Jeong Hong1. 1. Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea. 2. Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. 3. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
Abstract
OBJECTIVES: The association between the time from arrest to extracorporeal cardiopulmonary resuscitation (ECPR) and survival from out-of-hospital cardiac arrest (OHCA) is unclear. The aim of this study was to determine whether time to ECPR is associated with survival in OHCA. METHODS: We analysed the Korean national OHCA registry from 2013 to 2016. We included adult witnessed OHCA patients with presumed cardiac aetiology who underwent ECPR. Patients were excluded if their arrest times or outcomes were unknown. The primary outcome was survival to discharge. Multivariable logistic regression analysis controlling for potential confounders was conducted and adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated to determine the association between time to ECPR and survival. RESULTS: There were 40 352 witnessed OHCAs with presumed cardiac aetiology. One hundred and forty patients had ECPR applied on arriving at their ED, 13 of these patients survived to discharge and seven were neurologically intact. Median time from arrest to ECPR was 74 min (IQR 61-90). Time from arrest to ECPR was significantly and inversely associated with survival to discharge for every 10 min increase in time (AOR 0.73, 95% CI 0.53-1.00) in 10 min intervals. AOR for time from arrest to ECPR ≤60 min was independently associated with improved survival (AOR 6.48, 95% CI 1.54-27.20). CONCLUSION: Early initiation of ECPR is associated with improved survival after OHCA. Because we analysed a nationwide OHCA registry, which lacks uniform selection criteria for ECPR, further prospective study is warranted.
OBJECTIVES: The association between the time from arrest to extracorporeal cardiopulmonary resuscitation (ECPR) and survival from out-of-hospital cardiac arrest (OHCA) is unclear. The aim of this study was to determine whether time to ECPR is associated with survival in OHCA. METHODS: We analysed the Korean national OHCA registry from 2013 to 2016. We included adult witnessed OHCA patients with presumed cardiac aetiology who underwent ECPR. Patients were excluded if their arrest times or outcomes were unknown. The primary outcome was survival to discharge. Multivariable logistic regression analysis controlling for potential confounders was conducted and adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated to determine the association between time to ECPR and survival. RESULTS: There were 40 352 witnessed OHCAs with presumed cardiac aetiology. One hundred and forty patients had ECPR applied on arriving at their ED, 13 of these patients survived to discharge and seven were neurologically intact. Median time from arrest to ECPR was 74 min (IQR 61-90). Time from arrest to ECPR was significantly and inversely associated with survival to discharge for every 10 min increase in time (AOR 0.73, 95% CI 0.53-1.00) in 10 min intervals. AOR for time from arrest to ECPR ≤60 min was independently associated with improved survival (AOR 6.48, 95% CI 1.54-27.20). CONCLUSION: Early initiation of ECPR is associated with improved survival after OHCA. Because we analysed a nationwide OHCA registry, which lacks uniform selection criteria for ECPR, further prospective study is warranted.
Authors: Hyouk Jae Lim; Young Sun Ro; Ki Hong Kim; Jeong Ho Park; Ki Jeong Hong; Kyoung Jun Song; Sang Do Shin Journal: J Clin Med Date: 2021-12-29 Impact factor: 4.241
Authors: Loes Mandigers; Eric Boersma; Corstiaan A den Uil; Diederik Gommers; Jan Bělohlávek; Mirko Belliato; Roberto Lorusso; Dinis Dos Reis Miranda Journal: Interact Cardiovasc Thorac Surg Date: 2022-09-09