Clinical outcomes among out-of-hospital cardiac arrest patients treated by extracorporeal cardiopulmonary resuscitation: The CRITICAL study in Osaka

• Published in: Resuscitation Vol. 178; pp. 116 - 123
• Main Authors: Okada, Yohei, Irisawa, Taro, Yamada, Tomoki, Yoshiya, Kazuhisa, Park, Changhwi, Nishimura, Tetsuro, Ishibe, Takuya, Kobata, Hitoshi, Kiguchi, Takeyuki, Kishimoto, Masafumi, Kim, Sung-Ho, Ito, Yusuke, Sogabe, Taku, Morooka, Takaya, Sakamoto, Haruko, Suzuki, Keitaro, Onoe, Atsunori, Matsuyama, Tasuku, Kobayashi, Daisuke, Nishioka, Norihiro, Matsui, Satoshi, Yoshimura, Satoshi, Kimata, Shunsuke, Kawai, Shunsuke, Makino, Yuto, Kiyohara, Kosuke, Zha, Ling, Kitamura, Tetsuhisa, Iwami, Taku
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.09.2022
• Subjects: ECPR; Out-of-hospital cardiac arrest; SAVE-J study; Ventricular fibrillation; ECPR; Out-of-hospital cardiac arrest; SAVE-J study; Ventricular fibrillation
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/j.resuscitation.2022.06.007

Extracorporeal cardiopulmonary resuscitation (ECPR) is performed in refractory out-of-hospital cardiac arrest (OHCA) patients, and the eligibility has been conventionally determined based on three criteria (initial cardiac rhythm, time to hospital arrival within 45 minutes, and age <75 years) in Japan. Owing to limited information, this study descriptively determined neurological outcomes after applying the three criteria among OHCA patients who underwent ECPR. This study conducted a post-hoc analysis of data from the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study. This was a multi-institutional prospective observational study of OHCA patients in Osaka Prefecture, Japan. All adult (aged ≥18 years) OHCA patients with internal medical causes treated with ECPR between 1 July 2012 and 31 December 2019 were evaluated. We described one-month neurological favourable outcomes based on the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and we compared them using the chi-square test. Among 18,379 patients screened from the CRITICAL study database, we included 517 OHCA patients treated by ECPR; 311 (60.2%) patients met all three criteria. Favourable neurological outcomes were as follows: patients meeting no or one criterion: 2.3% (1/43), those meeting two criteria: 8% (13/163), and those meeting all criteria: 16.1% (50/311) (P-value = 0.004). In this study, approximately 60% of patients treated by ECPR met the three criteria (initial shockable, time to hospital arrival within 45 minutes, and age <75 years), and the greater the number of criteria met, the better were the neurological outcomes achieved.