Critical Care (May 2022)
Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan
- Akihiko Inoue,
- Toru Hifumi,
- Tetsuya Sakamoto,
- Hiroshi Okamoto,
- Jun Kunikata,
- Hideto Yokoi,
- Hirotaka Sawano,
- Yuko Egawa,
- Shunichi Kato,
- Kazuhiro Sugiyama,
- Naofumi Bunya,
- Takehiko Kasai,
- Shinichi Ijuin,
- Shinichi Nakayama,
- Jun Kanda,
- Seiya Kanou,
- Toru Takiguchi,
- Shoji Yokobori,
- Hiroaki Takada,
- Kazushige Inoue,
- Ichiro Takeuchi,
- Hiroshi Honzawa,
- Makoto Kobayashi,
- Tomohiro Hamagami,
- Wataru Takayama,
- Yasuhiro Otomo,
- Kunihiko Maekawa,
- Takafumi Shimizu,
- Satoshi Nara,
- Michitaka Nasu,
- Kuniko Takahashi,
- Yoshihiro Hagiwara,
- Shigeki Kushimoto,
- Reo Fukuda,
- Takayuki Ogura,
- Shin-ichiro Shiraishi,
- Ryosuke Zushi,
- Norio Otani,
- Migaku Kikuchi,
- Kazuhiro Watanabe,
- Takuo Nakagami,
- Tomohisa Shoko,
- Nobuya Kitamura,
- Takayuki Otani,
- Yoshinori Matsuoka,
- Makoto Aoki,
- Masaaki Sakuraya,
- Hideki Arimoto,
- Koichiro Homma,
- Hiromichi Naito,
- Shunichiro Nakao,
- Tomoya Okazaki,
- Yoshio Tahara,
- Yasuhiro Kuroda,
- the SAVE-J II study group
Affiliations
- Akihiko Inoue
- Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center
- Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
- Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University School of Medicine
- Hiroshi Okamoto
- Department of Critical Care Medicine, St. Luke’s International Hospital
- Jun Kunikata
- Clinical Research Support Center, Kagawa University Hospital
- Hideto Yokoi
- Clinical Research Support Center, Kagawa University Hospital
- Hirotaka Sawano
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
- Yuko Egawa
- Advanced Emergency and Critical Care Center, Saitama Red Cross Hospital
- Shunichi Kato
- Advanced Emergency and Critical Care Center, Saitama Red Cross Hospital
- Kazuhiro Sugiyama
- Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital
- Naofumi Bunya
- Department of Emergency Medicine, Sapporo Medical University
- Takehiko Kasai
- Department of Emergency Medicine, Sapporo Medical University
- Shinichi Ijuin
- Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center
- Shinichi Nakayama
- Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center
- Jun Kanda
- Department of Emergency Medicine, Teikyo University School of Medicine
- Seiya Kanou
- Department of Emergency Medicine, Teikyo University School of Medicine
- Toru Takiguchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School
- Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School
- Hiroaki Takada
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center
- Kazushige Inoue
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center
- Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center
- Hiroshi Honzawa
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center
- Makoto Kobayashi
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital
- Tomohiro Hamagami
- Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital
- Wataru Takayama
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine
- Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine
- Kunihiko Maekawa
- Department of Emergency Medicine, Hokkaido University Hospital
- Takafumi Shimizu
- Emergency and Critical Care Medical Center, Teine Keijinkai Hospital
- Satoshi Nara
- Emergency and Critical Care Medical Center, Teine Keijinkai Hospital
- Michitaka Nasu
- Department of Emergency and Critical Care Medicine, Urasoe General Hospital
- Kuniko Takahashi
- Department of Emergency and Critical Care Medicine, Urasoe General Hospital
- Yoshihiro Hagiwara
- Department of Emergency Medicine and Critical Care Medicine Tochigi Prefectural Emergency and Critical Care Center, Imperial Gift Foundation Saiseikai, Utsunomiya Hospital
- Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine
- Reo Fukuda
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital
- Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine Tochigi Prefectural Emergency and Critical Care Center, Imperial Gift Foundation Saiseikai, Utsunomiya Hospital
- Shin-ichiro Shiraishi
- Department of Emergency and Critical Care Medicine, Aizu Central Hospital
- Ryosuke Zushi
- Emergency Medicine, Osaka Mishima Emergency Critical Care Center
- Norio Otani
- Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
- Migaku Kikuchi
- Emergency and Critical Care Center, Dokkyo Medical University
- Kazuhiro Watanabe
- Department of Cardiology, Nihon University Hospital
- Takuo Nakagami
- Department of Cardiovascular Medicine, Omihachiman Community Medical Center
- Tomohisa Shoko
- Department of Emergency and Critical Care Medicine, Tokyo Women’s Medical University Medical Center East
- Nobuya Kitamura
- Department of Emergency and Critical Care Medicine, Kimitsu Chuo Hospital
- Takayuki Otani
- Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital
- Yoshinori Matsuoka
- Department of Emergency Medicine, Kobe City Medical Center General Hospital
- Makoto Aoki
- Department of Emergency Medicine, Gunma University Graduate School of Medicine
- Masaaki Sakuraya
- Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital
- Hideki Arimoto
- Emergency and Critical Care Medical Center, Osaka City General Hospital
- Koichiro Homma
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine
- Hiromichi Naito
- Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
- Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
- Tomoya Okazaki
- Department of Emergency, Disaster and Critical Care Medicine, Kagawa University Hospital
- Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Yasuhiro Kuroda
- Department of Emergency, Disaster and Critical Care Medicine, Kagawa University Hospital
- the SAVE-J II study group
- DOI
- https://doi.org/10.1186/s13054-022-03998-y
- Journal volume & issue
-
Vol. 26,
no. 1
pp. 1 – 11
Abstract
Abstract Background The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.
Keywords
- Real-world data
- Extracorporeal cardiopulmonary resuscitation
- Out-of-hospital cardiac arrest
- Neurological outcome
- Survival rate
- Complication
