The effect of extracorporeal cardiopulmonary resuscitation in re-arrest after survival event: a retrospective analysis

Kap Su Han, Su Jin Kim, Eui Jung Lee, Sung Woo Lee

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    1 Citation (Scopus)

    Abstract

    Background: The objectives of this study were to 1) identify the risk factors for predicting re-arrest and 2) determine whether extracorporeal cardiopulmonary resuscitation results in better outcomes than conventional cardiopulmonary resuscitation for managing re-arrest in out-of-hospital cardiac arrest patients. Methods: This retrospective analysis was based on a prospective cohort. We included adult patients with non-traumatic out-of-hospital cardiac arrest who achieved a survival event. The primary measurement was re-arrest, defined as recurrent cardiac arrest within 24 hours after survival event. Multiple logistic regression analysis was used to predict re-arrest. Subgroup analysis was performed to evaluate the effect of extracorporeal cardiopulmonary resuscitation on the survival to discharge in out-of-hospital cardiac arrest patients who experienced re-arrest. Results: Of 534 patients suitable for inclusion, 203 (38.0%) were enrolled in the re-arrest group. Old age, prolonged advanced cardiac life support duration and the presence of hypotension at 0 hours after survival event were independent variables predicting re-arrest. In the re-arrest group, the extracorporeal cardiopulmonary resuscitation group (n = 25) showed better outcomes than the conventional cardiopulmonary resuscitation group. However, multiple logistic regression for predicting survival to discharge revealed that extracorporeal cardiopulmonary resuscitation was not an independent factor. Multiple logistic regression revealed that a hypotensive state at re-arrest was an independent risk factor for survival. Conclusion: Alternative methods that reduce the advanced cardiac life support duration should be considered to prevent re-arrest and attain good outcomes in out-of-hospital cardiac arrest patients. Extracorporeal cardiopulmonary resuscitation for re-arrest tended to show a good outcome compared to conventional cardiopulmonary resuscitation for re-arrest. Avoiding or immediately correcting hypotension may prevent re-arrest and improve the outcome of re-arrested patients.

    Original languageEnglish
    Pages (from-to)39-47
    Number of pages9
    JournalPerfusion (United Kingdom)
    Volume35
    Issue number1
    DOIs
    Publication statusPublished - 2020 Jan 1

    Keywords

    • conventional cardiopulmonary resuscitation
    • extracorporeal cardiopulmonary resuscitation
    • out-of-hospital cardiac arrest
    • re-arrest
    • survival event

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Safety Research
    • Cardiology and Cardiovascular Medicine
    • Advanced and Specialised Nursing

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