Abstract 165: Impact of Prehospital Epinephrine for Patients Treated With Extracorporeal Cardiopulmonary Resuscitation After Refractory Out-Of-Hospital Shockable Cardiac Arrest
| Autor: | David F. Gaieski, Yoshio Tahara, Chiba Nobutaka, Hiroshi Nonogi, Naoki Sato, Takanori Ikeda, Tsukasa Yagi, Eizo Tachibana, Noritoshi Ito, Naohiro Yonemoto, Ken Nagao |
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| Rok vydání: | 2019 |
| Předmět: |
Out of hospital
business.industry medicine.medical_treatment Drug administration medicine.disease Epinephrine Refractory Physiology (medical) Anesthesia Ventricular fibrillation medicine Extracorporeal cardiopulmonary resuscitation Cardiopulmonary resuscitation Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Circulation. 140 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background: The 2015 CoSTR recommended that standard-dose epinephrine (SDE) was reasonable for patients with out-of-hospital cardiac arrest (OHCA) and extracorporeal cardiopulmonary resuscitation (ECPR) was reasonable rescue therapy for selected patients with ongoing cardiac arrest when initial conventional CPR was unsuccessful. We investigated the effect of prehospital SDE for patients who met the criteria of ECPR. Methods: From the All-Japan OHCA Utstein Registry between 2007 and 2015, we included 22,552 patients who met the criteria of ECPR of the SAVE-J study (age between 20 and 75, witnessed shockable OHCA, cardiac arrest on hospital arrival, cardiac etiology, and collapse-to-ECPR interval within 60 minutes). Study patients were divided into two groups according to prehospital SDE or not. Primary endpoint was favorable 30-day neurological outcome after OHCA. Results: Of the 22,552 study patients, 5,659 (25%) received prehospital SDE and 16,893 (75%) did not. The SDE group resulted in lower proportion of favorable 30-day neurological outcome than the no-SDE group (5.6% versus 8.4%, p Conclusions: Prehospital SDE did not improve likelihood of favorable neurological outcome for patients who met the criteria of ECPR (age between 20 and 75, witnessed shockable OHCA, cardiac arrest on hospital arrival, cardiac etiology and collapse-to-ECPR interval within 60 minutes), because SED administration delayed the collapse-to-hospital-arrival interval which was closely related to the neurologically intact survival on ECPR. |
| Databáze: | OpenAIRE |
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