Patients with refractory out-of-cardiac arrest and sustained ventricular fibrillation as candidates for extracorporeal cardiopulmonary resuscitation: Prospective multi-center observational study

for the SAVE-J Group

研究成果: Article査読

20 被引用数 (Scopus)

抄録

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).

本文言語English
ページ(範囲)1011-1018
ページ数8
ジャーナルCirculation Journal
83
5
DOI
出版ステータスPublished - 2019

ASJC Scopus subject areas

  • 循環器および心血管医学

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