• Fernando Rosell Ortiz, Javier García Del Águila, Patricia Fernández Del Valle, J Mellado-Vergel Francisco F Servicio de Urgencias, Hospital el Toyo, Almería, España., Santiago Vergara-Pérez, María R Ruiz-Montero, Manuela Martínez-Lara, Francisco José Gómez-Jiménez, Ismael Gonzáez-Lobato, Guillermo García-Escudero, Manuel Ruiz-Bailén, Auxiliadora Caballero-García, Itziar Vivar-Díaz, and Luis Olavarría-Govantes.
• Empresa Pública de Emergencias Sanitarias de Andalucía, Almería, España.
• Emergencias. 2018 Jun 1; 30 (3): 156-162.

ObjectivesTo assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport.Material And MethodsRetrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome.ResultsOut of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91-10.76); P<.001)], witnessed OHCA (OR, 1.62; 95% CI, 1.16-2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38-4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07-2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17-2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58-4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24-2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome.ConclusionAmbulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.

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