1. The Association of Extreme Tachycardia and Sustained Return of Spontaneous Circulation after Nontraumatic Out-of-Hospital Cardiac Arrest
- Author
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Eugi Jung, Joonghee Kim, Yu Jin Kim, Seung Min Park, Dong Keon Lee, You Hwan Jo, and Jae Hyuk Lee
- Subjects
Bradycardia ,Tachycardia ,medicine.medical_specialty ,Article Subject ,RC86-88.9 ,business.industry ,medicine.medical_treatment ,Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,Emergency department ,Odds ratio ,030204 cardiovascular system & hematology ,Return of spontaneous circulation ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Heart rate ,Emergency Medicine ,medicine ,Cardiology ,Cardiopulmonary resuscitation ,medicine.symptom ,business ,Research Article - Abstract
Objective. Heart rate (HR), an essential vital sign that reflects hemodynamic stability, is influenced by myocardial oxygen demand, coronary blood flow, and myocardial performance. HR at the time of the return of spontaneous circulation (ROSC) could be influenced by the β1-adrenergic effect of the epinephrine administered during cardiopulmonary resuscitation (CPR), and its effect could be decreased in patients who have the failing heart. We aimed to investigate the association between HR at the time of ROSC and the outcomes of adult out-of-hospital cardiac arrest (OHCA) patients. Methods. This study was a secondary analysis of a cardiac arrest registry from a single institution from January 2008 to July 2014. The OHCA patients who achieved ROSC at the emergency department (ED) were included, and HR was retrieved from an electrocardiogram or vital sign at the time of ROSC. The patients were categorized into four groups according to the HR (bradycardia (HR Results. A total of 330 patients were included. In the univariate logistic regression model, the rate of sustained ROSC increased by 17% as HR increased by every 10 beats per minute (bpm) (odds ratio (OR), 1.171; 95% confidence interval (CI), 1.077–1.274, p<0.001). In the multivariate logistic regression model, extreme tachycardia was independently associated with a high probability of sustained ROSC compared to normal heart rate (OR, 15.96; 95% CI, 2.04–124.93, p=0.008). Conclusion. Extreme tachycardia (HR ≥ 150) at the time of ROSC is independently associated with a high probability of sustained ROSC in nontraumatic adult OHCA patients.
- Published
- 2020