Details

Autor(en) / Beteiligte

• Nakashima, Takahiro
• Noguchi, Teruo
• Tahara, Yoshio
• Nishimura, Kunihiro
• Ogata, Soshiro
• Yasuda, Satoshi
• Onozuka, Daisuke
• Morimura, Naoto
• Nagao, Ken
• Gaieski, David F
• Asai, Yasufumi
• Yokota, Hiroyuki
• Nara, Satoshi
• Hase, Mamoru
• Atsumi, Takahiro
• Sakamoto, Tetsuya
• Group, for the SAVE-J

Titel

Patients With Refractory Out-of-Cardiac Arrest and Sustained Ventricular Fibrillation as Candidates for Extracorporeal Cardiopulmonary Resuscitation　― Prospective Multi-Center Observational Study

Ist Teil von

• Circulation Journal, 2019/04/25, Vol.83(5), pp.1011-1018

Ort / Verlag

Japan: The Japanese Circulation Society

Erscheinungsjahr

2019

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) and sustained ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) or conversion to pulseless electrical activity/asystole (PEA/asystole) benefit more from extracorporeal cardiopulmonary resuscitation (ECPR). Methods and Results: We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, which was a prospective, multicenter, observational study with 22 institutions in the ECPR group and 17 institutions in the conventional CPR (CCPR) group. Patients were divided into 4 groups by cardiac rhythm and CPR group. The primary endpoint was favorable neurological outcome, defined as Cerebral Performance Category 1 or 2 at 6 months. A total of 407 patients had refractory OHCA with VF/pVT on initial electrocardiogram. The proportion of ECPR patients with favorable neurological outcome was significantly higher in the sustained VF/pVT group than in the conversion to PEA/asystole group (20%, 25/126 vs. 3%, 4/122, P<0.001). Stratifying by cardiac rhythm, on multivariable mixed logistic regression analysis an ECPR strategy significantly increased the proportion of patients with favorable neurological outcome at 6 months in the patients with sustained VF/pVT (OR, 7.35; 95% CI: 1.58–34.09), but these associations were not observed in patients with conversion to PEA/asystole. Conclusions: OHCA patients with sustained VF/pVT may be the most promising ECPR candidates (UMIN000001403).