Uncontrolled donation programs after out-of-hospital cardiac arrest. An estimation of potential donors.

Autor: Navalpotro-Pascual JM; SUMMA 112, Madrid, Spain. Electronic address: chemanp@gmail.com., Echarri-Sucunza A; Servicio de urgencias extrahospitalarias de Navarra, Navarra, Spain., Mateos-Rodríguez A; Oficina regional Coordinacion de Trasplantes, Consejería de Sanidad, Comunidad de Madrid Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Madrid, Spain., Peinado-Vallejo F; SUMMA 112, Madrid, Spain., Del Valle PF; Hospital Virgen del Rocío, Sevilla, Andalucía, Spain., Alonso-Moreno D; Emergentziak-Emergencias, Osakidetza, Euzkadi, Spain., Del Pozo-Pérez C; Emergencias Sanitarias, Castilla y León, Spain., Mier-Ruiz MV; Servicio de Emergencias 061 Cantabria, Cantabria, Spain., Ruiz-Azpiazu JI; Servicio de Urgencias y Emergencias 061, Spain., Bravo-Castello J; Emergencias sanitarias de Extremadura, Extremadura, Spain., Martinez-Cuellar N; SAMU 061 Baleares, Islas Baleares, Spain., Sáez-Jiménez A; Servicio de Emergencias 061, Murcia, Spain., López-Unanua C; Fundación Pública Urxencias Sanitarias 061, Galicia, Spain., Antón-Ramas R; 061 e Instituto de Ciencias de la Salud, Aragón, Spain., Escriche-López MDC; SAMU, Emergencias Sanitarias, Comunidad Valenciana, Spain., Giraldo-Sebastià JM; Sistema Emergencies Mediques, Catalunya, Spain., García-Ochoa MJ; SAMUR Protección Civil, Madrid, Spain., Martín-Sánchez E; Servicio de Urgencias Canario, Islas Canarias, Spain., Borraz-Clares D; Servicio de Bomberos de Zaragoza, Aragón, Spain., Del Valle MM; SAMU-Asturias, Asturias, Spain., Carriedo-Scher C; Servicio de Urgencias y Emergencias, Castilla La Mancha, Spain., Rosell-Ortiz F; Empresa Pública de Emergencias Sanitarias, Almería, Andalucía, Spain.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2018 Jan; Vol. 122, pp. 87-91. Date of Electronic Publication: 2017 Nov 26.
DOI: 10.1016/j.resuscitation.2017.11.059
Abstrakt: Objective: To determine the number of potential deceased organ donors from out-of- hospital cardiac arrest cases (OHCA) attended by public physician-led emergency medical services in Spain, based on data recorded in the nationwide Spanish OHCA Registry (OHSCAR).
Material and Methods: We analysed OHSCAR data on deceased OHCA patients in Spain during 13 months (1/10/2013 to 31/10/2014). Variables included age, sex, estimated OHCA time, cardiopulmonary resuscitation (CPR) start time and outcome. Inclusion criteria were: age 16-60 years, witnessed OHCA, no return of spontaneous circulation (ROSC) and time interval <15min between OHCA occurrence and CPR initiation.
Results: Of a total 8789 cases, 3290 met the age criteria; of these, CPR was not witnessed in 745 cases. Among the remaining 2545 patients, 141 were included in uncontrolled donation after cardiac death (uDCD) programs, 902 arrived at the hospital with ROSC, 64 arrived with ongoing CPR and 15 cases were lost to follow-up. Of the remaining 1423 without ROSC, CPR initiation time was not recorded in 454 cases and 398 did not meet the time criteria <15min between OHCA and CPR initiation. Finally, 571 met all the criteria and could have been potential donors. There were significant differences in the actual donors percentage from potential donors percentage between provinces with and without donor programs (141/322=43.8% versus 0/390=0%), but there were no differences in ROSC between the two types of provinces (418/1320=31.7% versus 652/1970=33.4%).
Conclusions: Many potential donors are missed in current clinical practice. uDCD programs are few and underused even in a country with high rates of organ transplantation.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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