Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study
Abstract Background The impact of the chronological sequence of events, including cardiac arrest (CA), initial cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), and extracorporeal cardiopulmonary resuscitation (ECPR) implementation, on clinical outcomes in patients with...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-023-00905-8 |
| _version_ | 1797275651701473280 |
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| author | Amir Vahedian-Azimi Ibrahim Fawzy Hassan Farshid Rahimi-Bashar Hussam Elmelliti Mahmood Salesi Hazim Alqahwachi Fatima Albazoon Anzila Akbar Ahmed Labib Shehata Abdulsalam Saif Ibrahim Ali Ait Hssain |
| author_facet | Amir Vahedian-Azimi Ibrahim Fawzy Hassan Farshid Rahimi-Bashar Hussam Elmelliti Mahmood Salesi Hazim Alqahwachi Fatima Albazoon Anzila Akbar Ahmed Labib Shehata Abdulsalam Saif Ibrahim Ali Ait Hssain |
| author_sort | Amir Vahedian-Azimi |
| collection | DOAJ |
| description | Abstract Background The impact of the chronological sequence of events, including cardiac arrest (CA), initial cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), and extracorporeal cardiopulmonary resuscitation (ECPR) implementation, on clinical outcomes in patients with both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), is still not clear. The aim of this study was to investigate the prognostic effects of the time interval from collapse to start of CPR (no-flow time, NFT) and the time interval from start of CPR to implementation of ECPR (low-flow time, LFT) on patient outcomes under Extracorporeal Membrane Oxygenation (ECMO). Methods This single-center, retrospective observational study was conducted on 48 patients with OHCA or IHCA who underwent ECMO at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. We investigated the impact of prognostic factors such as NFT and LFT on various clinical outcomes following cardiac arrest, including 24-hour survival, 28-day survival, CPR duration, ECMO length of stay (LOS), ICU LOS, hospital LOS, disability (assessed using the modified Rankin Scale, mRS), and neurological status (evaluated based on the Cerebral Performance Category, CPC) at 28 days after the CA. Results The results of the adjusted logistic regression analysis showed that a longer NFT was associated with unfavorable clinical outcomes. These outcomes included longer CPR duration (OR: 1.779, 95%CI: 1.218–2.605, P = 0.034) and decreased survival rates for ECMO at 24 h (OR: 0.561, 95%CI: 0.183–0.903, P = 0.009) and 28 days (OR: 0.498, 95%CI: 0.106–0.802, P = 0.011). Additionally, a longer LFT was found to be associated only with a higher probability of prolonged CPR (OR: 1.818, 95%CI: 1.332–3.312, P = 0.006). However, there was no statistically significant connection between either the NFT or the LFT and the improvement of disability or neurologically favorable survival after 28 days of cardiac arrest. Conclusions Based on our findings, it has been determined that the NFT is a more effective predictor than the LFT in assessing clinical outcomes for patients with OHCA or IHCA who underwent ECMO. This understanding of their distinct predictive abilities enables medical professionals to identify high-risk patients more accurately and customize their interventions accordingly. |
| first_indexed | 2024-03-07T15:16:32Z |
| format | Article |
| id | doaj.art-e7234f98f13341949a56104607d3b058 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-07T15:16:32Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-e7234f98f13341949a56104607d3b0582024-03-05T17:53:29ZengBMCBMC Emergency Medicine1471-227X2024-03-0124111510.1186/s12873-023-00905-8Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational studyAmir Vahedian-Azimi0Ibrahim Fawzy Hassan1Farshid Rahimi-Bashar2Hussam Elmelliti3Mahmood Salesi4Hazim Alqahwachi5Fatima Albazoon6Anzila Akbar7Ahmed Labib Shehata8Abdulsalam Saif Ibrahim9Ali Ait Hssain10Trauma research center, Nursing Faculty, Baqiyatallah University of Medical SciencesMedical Intensive Care Unit, Hamad General HospitalDepartment of Anesthesiology and Critical Care, School of medicine, Hamadan University of Medical SciencesEmergency Department, Hamad General HospitalChemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical SciencesMedical Education, Hamad Medical CorporationMedical Research Center, Hamad Medical CorporationTrauma research center, Nursing Faculty, Baqiyatallah University of Medical SciencesMedical Intensive Care Unit, Hamad General HospitalMedical Intensive Care Unit, Hamad General HospitalMedical Intensive Care Unit, Hamad General HospitalAbstract Background The impact of the chronological sequence of events, including cardiac arrest (CA), initial cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), and extracorporeal cardiopulmonary resuscitation (ECPR) implementation, on clinical outcomes in patients with both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), is still not clear. The aim of this study was to investigate the prognostic effects of the time interval from collapse to start of CPR (no-flow time, NFT) and the time interval from start of CPR to implementation of ECPR (low-flow time, LFT) on patient outcomes under Extracorporeal Membrane Oxygenation (ECMO). Methods This single-center, retrospective observational study was conducted on 48 patients with OHCA or IHCA who underwent ECMO at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. We investigated the impact of prognostic factors such as NFT and LFT on various clinical outcomes following cardiac arrest, including 24-hour survival, 28-day survival, CPR duration, ECMO length of stay (LOS), ICU LOS, hospital LOS, disability (assessed using the modified Rankin Scale, mRS), and neurological status (evaluated based on the Cerebral Performance Category, CPC) at 28 days after the CA. Results The results of the adjusted logistic regression analysis showed that a longer NFT was associated with unfavorable clinical outcomes. These outcomes included longer CPR duration (OR: 1.779, 95%CI: 1.218–2.605, P = 0.034) and decreased survival rates for ECMO at 24 h (OR: 0.561, 95%CI: 0.183–0.903, P = 0.009) and 28 days (OR: 0.498, 95%CI: 0.106–0.802, P = 0.011). Additionally, a longer LFT was found to be associated only with a higher probability of prolonged CPR (OR: 1.818, 95%CI: 1.332–3.312, P = 0.006). However, there was no statistically significant connection between either the NFT or the LFT and the improvement of disability or neurologically favorable survival after 28 days of cardiac arrest. Conclusions Based on our findings, it has been determined that the NFT is a more effective predictor than the LFT in assessing clinical outcomes for patients with OHCA or IHCA who underwent ECMO. This understanding of their distinct predictive abilities enables medical professionals to identify high-risk patients more accurately and customize their interventions accordingly.https://doi.org/10.1186/s12873-023-00905-8Cardiac arrestCardiopulmonary resuscitationExtracorporeal circulationExtracorporeal membrane oxygenation out-of-hospital cardiac arrestIn-hospital cardiac arrestPrognosis |
| spellingShingle | Amir Vahedian-Azimi Ibrahim Fawzy Hassan Farshid Rahimi-Bashar Hussam Elmelliti Mahmood Salesi Hazim Alqahwachi Fatima Albazoon Anzila Akbar Ahmed Labib Shehata Abdulsalam Saif Ibrahim Ali Ait Hssain Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study BMC Emergency Medicine Cardiac arrest Cardiopulmonary resuscitation Extracorporeal circulation Extracorporeal membrane oxygenation out-of-hospital cardiac arrest In-hospital cardiac arrest Prognosis |
| title | Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study |
| title_full | Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study |
| title_fullStr | Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study |
| title_full_unstemmed | Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study |
| title_short | Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study |
| title_sort | prognostic effects of cardiopulmonary resuscitation cpr start time and the interval between cpr to extracorporeal cardiopulmonary resuscitation ecpr on patient outcomes under extracorporeal membrane oxygenation ecmo a single center retrospective observational study |
| topic | Cardiac arrest Cardiopulmonary resuscitation Extracorporeal circulation Extracorporeal membrane oxygenation out-of-hospital cardiac arrest In-hospital cardiac arrest Prognosis |
| url | https://doi.org/10.1186/s12873-023-00905-8 |
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