Long-Term Prognostic Value of Gasping During Out-of-Hospital Cardiac Arrest
| Autor: | Tom P. Aufderheide, Brian J. O'Neil, Guillaume Debaty, Ralph J. Frascone, Marvin A. Wayne, Robert M. Domeier, Michael L. Olinger, Keith G. Lurie, Brian D. Mahoney, José Labarère, Robert A. Swor, Demetris Yannopoulos |
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| Přispěvatelé: | Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Biologie Computationnelle et Mathématique (TIMC-IMAG-BCM), University of Minnesota System, George Washington University Medical Center, The George Washington University (GW), Beaumont Hospital, University of Michigan System, Department of Medicine, and the Department of Pathology [Indianapolis, IN, USA] (School of Medicine), Indiana University System, Wayne State University [Detroit], Medical College of Wisconsin |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Resuscitation medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences Young Adult 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Internal medicine Medicine Humans Cardiopulmonary resuscitation Prospective Studies Prospective cohort study Survival rate ComputingMilieux_MISCELLANEOUS Aged Agonal respiration Aged 80 and over business.industry 030208 emergency & critical care medicine Odds ratio Middle Aged medicine.disease Prognosis 3. Good health Survival Rate Inhalation Anesthesia Ventricular fibrillation Ventricular Fibrillation Cardiology Tachycardia Ventricular Female medicine.symptom Cardiology and Cardiovascular Medicine business Clinical death Out-of-Hospital Cardiac Arrest |
| Zdroj: | Journal of the American College of Cardiology Journal of the American College of Cardiology, Elsevier, 2017, 70 (12), pp.1467-1476. ⟨10.1016/j.jacc.2017.07.782⟩ |
| ISSN: | 1558-3597 0735-1097 |
| DOI: | 10.1016/j.jacc.2017.07.782⟩ |
| Popis: | Background Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR). Objectives This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes. Methods The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health–funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009. The association between gasping and 1-year survival with favorable neurological function, defined as a Cerebral Performance Category (CPC) score ≤2 was estimated using multivariable logistic regression. Results The rates of 1-year survival with a CPC score of ≤2 were 5.4% (98 of 1,827) overall, and 20% (36 of 177) and 3.7% (61 of 1,643) for individuals with and without spontaneous gasping or agonal respiration during CPR, respectively. In multivariable analysis, 1-year survival with CPC ≤2 was independently associated with younger age (odds ratio [OR] for 1 SD increment 0.57; 95% confidence interval [CI]: 0.43 to 0.76), gasping during CPR (OR: 3.94; 95% CI: 2.09 to 7.44), shockable initial recorded rhythm (OR: 16.50; 95% CI: 7.40 to 36.81), shorter CPR duration (OR: 0.31; 95% CI: 0.19 to 0.51), lower epinephrine dosage (OR: 0.47; 95% CI: 0.25 to 0.87), and pulmonary edema (OR: 3.41; 95% CI: 1.53 to 7.60). Gasping combined with a shockable initial recorded rhythm had a 57-fold higher OR (95% CI: 23.49 to 136.92) of 1-year survival with CPC ≤2 versus no gasping and no shockable rhythm. Conclusions Gasping during CPR was independently associated with increased 1-year survival with CPC ≤2, regardless of the first recorded rhythm. These findings underscore the importance of not terminating resuscitation prematurely in gasping patients and the need to routinely recognize, monitor, and record data on gasping in all future cardiac arrest trials and registries. |
| Databáze: | OpenAIRE |
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