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Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest patients treated with cardiopulmonary resuscitation using extracorporeal life support
- Source :
- Resuscitation. 81:968-973
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- Aim Cardiopulmonary resuscitation (CPR) using extracorporeal life support (ECLS) for in-hospital cardiac arrest (IHCA) patients has been assigned a low-grade recommendation in current resuscitation guidelines. This study compared the outcomes of IHCA and out-of-hospital cardiac arrest (OHCA) patients treated with ECLS. Methods A total of 77 patients were treated with ECLS. Baselines characteristics and outcomes were compared for 38 IHCA and 39 OCHA patients. Results The time interval between collapse and starting ECLS was significantly shorter after IHCA than after OHCA (25 (21–43)min versus 59 (45–65)min, p p =0.03) and 30-day survival (34% versus 13%, p =0.03) were higher for IHCA compared with OHCA patients. IHCA patients had a higher rate of favourable neurological outcome compared to OHCA patients, but the difference was not statistically significant (26% versus 10%, p =0.07). Kaplan–Meier analysis showed improved 30-day and 1-year survival for IHCA patients treated with ECLS compared to OHCA patients who had ECLS. However, multivariate stepwise Cox regression model analysis indicated no difference in 30-day (odds ratio 0.94 (95% confidence interval 0.68–1.27), p =0.67) and 1-year survival (0.99 (0.73–1.33), p =0.95). Conclusion CPR with ECLS led to more favourable patient outcomes after IHCA compared with OHCA in our patient group. The difference in outcomes for ECLS after IHCA and OHCA disappeared after adjusting for patient factors and the time delay in starting ECLS.
- Subjects :
- Male
Emergency Medical Services
Extracorporeal Circulation
endocrine system
Resuscitation
medicine.medical_specialty
medicine.medical_treatment
Emergency Nursing
law.invention
Japan
law
Intensive care
Outpatients
Cardiopulmonary bypass
medicine
Extracorporeal membrane oxygenation
Humans
Extracorporeal cardiopulmonary resuscitation
Cardiopulmonary resuscitation
Aged
Retrospective Studies
Inpatients
business.industry
Odds ratio
Middle Aged
Cardiopulmonary Resuscitation
Heart Arrest
Surgery
Survival Rate
Intensive Care Units
Treatment Outcome
Life support
Anesthesia
Emergency Medicine
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 03009572
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....067e26d3e58085b15f797ebb53fe95e8