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Observational Study
Clinical outcomes among out-of-hospital cardiac arrest patients treated by extracorporeal cardiopulmonary resuscitation: The CRITICAL study in Osaka.
- Yohei Okada, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Hitoshi Kobata, Takeyuki Kiguchi, Masafumi Kishimoto, Sung-Ho Kim, Yusuke Ito, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Atsunori Onoe, Tasuku Matsuyama, Daisuke Kobayashi, Norihiro Nishioka, Satoshi Matsui, Satoshi Yoshimura, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Kosuke Kiyohara, Ling Zha, Tetsuhisa Kitamura, and Taku Iwami.
- Department of Preventive Services, School of Public Health/Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Emergency Medicine and Critical Care, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan.
- Resuscitation. 2022 Sep 1; 178: 116-123.
AimExtracorporeal cardiopulmonary resuscitation (ECPR) is performed in refractory out-of-hospital cardiac arrest (OHCA) patients, and the eligibility has been conventionally determined based on three criteria (initial cardiac rhythm, time to hospital arrival within 45 minutes, and age <75 years) in Japan. Owing to limited information, this study descriptively determined neurological outcomes after applying the three criteria among OHCA patients who underwent ECPR.MethodsThis study conducted a post-hoc analysis of data from the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study. This was a multi-institutional prospective observational study of OHCA patients in Osaka Prefecture, Japan. All adult (aged ≥18 years) OHCA patients with internal medical causes treated with ECPR between 1 July 2012 and 31 December 2019 were evaluated. We described one-month neurological favourable outcomes based on the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and we compared them using the chi-square test.ResultsAmong 18,379 patients screened from the CRITICAL study database, we included 517 OHCA patients treated by ECPR; 311 (60.2%) patients met all three criteria. Favourable neurological outcomes were as follows: patients meeting no or one criterion: 2.3% (1/43), those meeting two criteria: 8% (13/163), and those meeting all criteria: 16.1% (50/311) (P-value = 0.004).ConclusionsIn this study, approximately 60% of patients treated by ECPR met the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and the greater the number of criteria met, the better were the neurological outcomes achieved.Copyright © 2022 Elsevier B.V. All rights reserved.
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