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Extracorporeal membrane oxygenation improves outcomes of accidental hypothermia without vital signs: A nationwide observational study.
- Source :
-
Resuscitation . Nov2019, Vol. 144, p27-32. 6p. - Publication Year :
- 2019
-
Abstract
- <bold>Aim: </bold>Patients with accidental hypothermia without vital signs increasingly receive venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, there is limited knowledge regarding the efficacy of this advanced rewarming method. We aimed to determine whether VA-ECMO improved outcomes in patients with accidental hypothermia without vital signs, using a large nationwide inpatient database in Japan.<bold>Methods: </bold>Using the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2017, we identified patients diagnosed with accidental hypothermia who received closed-chest cardiac massage in-hospital on the day of admission. Patients who received VA-ECMO on the day of admission were allocated to the VA-ECMO group, and those who received cardiopulmonary resuscitation (CPR) only were allocated to the conventional CPR group. The primary outcome was in-hospital mortality, and the secondary outcome was a Japan Coma Scale status of "alert consciousness" at discharge. Propensity score-matching analyses were performed to compare the outcomes.<bold>Results: </bold>We identified 1661 eligible patients during the 81-month study period, and 318 (19%) received VA-ECMO on the day of admission. Crude in-hospital mortality was 65% in the VA-ECMO group and 84% in the conventional CPR group. Propensity score-matching analyses demonstrated significantly lower in-hospital mortality (risk difference: -13%; 95% confidence interval: -21% to -5.1%) and a higher proportion of "alert consciousness" at discharge (risk difference: 8.3%; 95% confidence interval: 1.9%-15%) in the VA-ECMO group compared with the conventional CPR group.<bold>Conclusion: </bold>VA-ECMO was associated with higher survival and favourable neurological outcomes compared with conventional CPR alone in patients with accidental hypothermia without vital signs. [ABSTRACT FROM AUTHOR]
- Subjects :
- *EXTRACORPOREAL membrane oxygenation
*OXYGENATORS
*VITAL signs
*HYPOTHERMIA
*HOSPITAL mortality
*CARDIOPULMONARY resuscitation
*HYPOTHERMIA treatment
*COMPARATIVE studies
*DATABASES
*HOSPITAL care
*RESEARCH methodology
*MEDICAL cooperation
*PROBABILITY theory
*RESEARCH
*THERMOTHERAPY
*EVALUATION research
*TREATMENT effectiveness
Subjects
Details
- Language :
- English
- ISSN :
- 03009572
- Volume :
- 144
- Database :
- Academic Search Index
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 139347710
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2019.08.041