Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study
Abstract Background Gasping during resuscitation has been reported as a favorable factor for out-of-hospital cardiac arrest. We examined whether gasping during resuscitation is independently associated with favorable neurological outcomes in patients with refractory ventricular fibrillation or pulse...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Journal of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s40560-023-00692-1 |
| _version_ | 1797577798020235264 |
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| author | Satoshi Nara Naofumi Bunya Hirofumi Ohnishi Keigo Sawamoto Shuji Uemura Nobuaki Kokubu Mamoru Hase Eichi Narimatsu Yasufumi Asai Yoshio Tahara Takahiro Atsumi Ken Nagao Naoto Morimura Tetsuya Sakamoto SAVE-J Study Group |
| author_facet | Satoshi Nara Naofumi Bunya Hirofumi Ohnishi Keigo Sawamoto Shuji Uemura Nobuaki Kokubu Mamoru Hase Eichi Narimatsu Yasufumi Asai Yoshio Tahara Takahiro Atsumi Ken Nagao Naoto Morimura Tetsuya Sakamoto SAVE-J Study Group |
| author_sort | Satoshi Nara |
| collection | DOAJ |
| description | Abstract Background Gasping during resuscitation has been reported as a favorable factor for out-of-hospital cardiac arrest. We examined whether gasping during resuscitation is independently associated with favorable neurological outcomes in patients with refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) undergoing extracorporeal cardiopulmonary resuscitation ECPR. Methods Data from a 2014 study on advanced cardiac life support for ventricular fibrillation with extracorporeal circulation in Japan (SAVE-J), which examined the efficacy of ECPR for refractory VF/pVT, were analyzed. The primary endpoint was survival with a 6-month favorable neurological outcome in patients who underwent ECPR with or without gasping during resuscitation. Multivariate logistic regression analysis was performed to evaluate the association between gasping and outcomes. Results Of the 454 patients included in the SAVE-J study, data from 212 patients were analyzed in this study after excluding those with missing information and those who did not undergo ECPR. Gasping has been observed in 47 patients during resuscitation; 11 (23.4%) had a favorable neurological outcome at 6 months. Multivariate logistic regression analysis showed that gasping during resuscitation was independently associated with a favorable neurological outcome (odds ratio [OR], 10.58 [95% confidence interval (CI) 3.22–34.74]). The adjusted OR for gasping during emergency medical service transport and on arrival at the hospital was 27.44 (95% CI 5.65–133.41). Conclusions Gasping during resuscitation is a favorable factor in patients with refractory VF/pVT. Patients with refractory VF/pVT with continuously preserved gasping during EMS transportation to the hospital are expected to have more favorable outcomes. |
| first_indexed | 2024-03-10T22:14:05Z |
| format | Article |
| id | doaj.art-341da9cc97794c6a8bc54978de74d0f8 |
| institution | Directory Open Access Journal |
| issn | 2052-0492 |
| language | English |
| last_indexed | 2024-03-10T22:14:05Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj.art-341da9cc97794c6a8bc54978de74d0f82023-11-19T12:30:28ZengBMCJournal of Intensive Care2052-04922023-10-0111111010.1186/s40560-023-00692-1Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort studySatoshi Nara0Naofumi Bunya1Hirofumi Ohnishi2Keigo Sawamoto3Shuji Uemura4Nobuaki Kokubu5Mamoru Hase6Eichi Narimatsu7Yasufumi Asai8Yoshio Tahara9Takahiro Atsumi10Ken Nagao11Naoto Morimura12Tetsuya Sakamoto13SAVE-J Study GroupEmergency and Critical Care Medical Center, Teine Keijinkai HospitalDepartment of Emergency Medicine, Sapporo Medical UniversityDepartment of Public Health, Sapporo Medical UniversityDepartment of Emergency Medicine, Sapporo Medical UniversityDepartment of Emergency Medicine, Sapporo Medical UniversityDepartment of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical UniversityCardiovascular Center, Sapporo Teishinkai HospitalDepartment of Emergency Medicine, Sapporo Medical UniversityDepartment of Emergency Medicine, Sapporo Medical UniversityDepartment of Cardiovascular Emergency, National Cerebral and Cardiovascular CenterDepartment of Emergency Medicine, Seirei Hamamatsu General HospitalDepartment of Cardiology, Nihon University HospitalDepartment of Emergency Medicine, Teikyo University School of MedicineDepartment of Emergency Medicine, Teikyo University School of MedicineAbstract Background Gasping during resuscitation has been reported as a favorable factor for out-of-hospital cardiac arrest. We examined whether gasping during resuscitation is independently associated with favorable neurological outcomes in patients with refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) undergoing extracorporeal cardiopulmonary resuscitation ECPR. Methods Data from a 2014 study on advanced cardiac life support for ventricular fibrillation with extracorporeal circulation in Japan (SAVE-J), which examined the efficacy of ECPR for refractory VF/pVT, were analyzed. The primary endpoint was survival with a 6-month favorable neurological outcome in patients who underwent ECPR with or without gasping during resuscitation. Multivariate logistic regression analysis was performed to evaluate the association between gasping and outcomes. Results Of the 454 patients included in the SAVE-J study, data from 212 patients were analyzed in this study after excluding those with missing information and those who did not undergo ECPR. Gasping has been observed in 47 patients during resuscitation; 11 (23.4%) had a favorable neurological outcome at 6 months. Multivariate logistic regression analysis showed that gasping during resuscitation was independently associated with a favorable neurological outcome (odds ratio [OR], 10.58 [95% confidence interval (CI) 3.22–34.74]). The adjusted OR for gasping during emergency medical service transport and on arrival at the hospital was 27.44 (95% CI 5.65–133.41). Conclusions Gasping during resuscitation is a favorable factor in patients with refractory VF/pVT. Patients with refractory VF/pVT with continuously preserved gasping during EMS transportation to the hospital are expected to have more favorable outcomes.https://doi.org/10.1186/s40560-023-00692-1GaspingSign of lifeCardiopulmonary resuscitationExtracorporeal cardiopulmonary resuscitationOut-of-hospital cardiac arrest |
| spellingShingle | Satoshi Nara Naofumi Bunya Hirofumi Ohnishi Keigo Sawamoto Shuji Uemura Nobuaki Kokubu Mamoru Hase Eichi Narimatsu Yasufumi Asai Yoshio Tahara Takahiro Atsumi Ken Nagao Naoto Morimura Tetsuya Sakamoto SAVE-J Study Group Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study Journal of Intensive Care Gasping Sign of life Cardiopulmonary resuscitation Extracorporeal cardiopulmonary resuscitation Out-of-hospital cardiac arrest |
| title | Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study |
| title_full | Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study |
| title_fullStr | Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study |
| title_full_unstemmed | Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study |
| title_short | Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study |
| title_sort | long term prognostic significance of gasping in out of hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation a post hoc analysis of a multi center prospective cohort study |
| topic | Gasping Sign of life Cardiopulmonary resuscitation Extracorporeal cardiopulmonary resuscitation Out-of-hospital cardiac arrest |
| url | https://doi.org/10.1186/s40560-023-00692-1 |
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