• C Adler, C Paul, J Hinkelbein, G Michels, R Pfister, A Krings, A Lechleuthner, and R Stangl.
• Klinik III für Innere Medizin, Herzzentrum der Universität zu Köln, 50937, Köln, Deutschland. christoph.adler@uk-koeln.de.
• Anaesthesist. 2018 May 1; 67 (5): 343-350.

BackgroundMortality in patients with out-of-hospital cardiac arrest (OHCA) remains very high despite advances in resuscitation algorithms. Most of these patients die at the scene and do not reach hospital. It is currently the subject of discussion whether transport to hospital with ongoing cardiopulmonary resuscitation (CPR) improves survival and neurological outcome in patients with OHCA.ObjectiveThe aim of this study was to identify predictors of survival and good neurological outcome in patients after OHCA who were transported to hospital with ongoing CPR.Patients And MethodsA total of 70 consecutive patients with refractory OHCA (mean age 54.7 ± 15 years) transported to hospital with ongoing CPR were retrospectively analyzed. Neurological outcome was assessed after 30 days based on the Glasgow-Pittsburgh cerebral performance category (CPC).ResultsAfter 30 days 82.9% of the patients enrolled in the trial died (CPC score of 5), 8 patients (11.4%) showed a good neurological recovery with CPC scores of 1-2 and 4 patients (5.7%) had a poor neurological outcome with CPC scores of 3-4. Predictors of good neurological outcome were witnessed arrest, initial defibrillatable rhythm and serum lactate levels on admission. In all patients with good outcome, the index event for OHCA was from cardiac causes.ConclusionSelected patient collectives can benefit from transport to hospital with ongoing cardiopulmonary resuscitation (CPR).

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