Acute Medicine & Surgery (Jan 2021)
Variability of extracorporeal cardiopulmonary resuscitation practice in patients with out‐of‐hospital cardiac arrest from the emergency department to intensive care unit in Japan
- Toru Hifumi,
- Akihiko Inoue,
- Toru Takiguchi,
- Kazuhiro Watanabe,
- Takayuki Ogura,
- Tomoya Okazaki,
- Shinichi Ijuin,
- Ryosuke Zushi,
- Hideki Arimoto,
- Hiroaki Takada,
- Shinichirou Shiraishi,
- Yuko Egawa,
- Jun Kanda,
- Michitaka Nasu,
- Makoto Kobayashi,
- Masaaki Sakuraya,
- Hiromichi Naito,
- Shunichiro Nakao,
- Norio Otani,
- Ichiro Takeuchi,
- Naofumi Bunya,
- Takafumi Shimizu,
- Hirotaka Sawano,
- Wataru Takayama,
- Shigeki Kushimoto,
- Tomohisa Shoko,
- Makoto Aoki,
- Takayuki Otani,
- Yoshinori Matsuoka,
- Koichiro Homma,
- Kunihiko Maekawa,
- Yoshio Tahara,
- Reo Fukuda,
- Migaku Kikuchi,
- Takuo Nakagami,
- Yoshihiro Hagiwara,
- Nobuya Kitamura,
- Kazuhiro Sugiyama,
- Tetsuya Sakamoto,
- Yasuhiro Kuroda,
- SAVE‐J II Study Group
Affiliations
- Toru Hifumi
- Department of Emergency and Critical Care Medicine St. Luke’s International Hospital Tokyo Japan
- Akihiko Inoue
- Department of Emergency and Critical Care Medicine Hyogo Emergency Medical Center Kobe Japan
- Toru Takiguchi
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
- Kazuhiro Watanabe
- Department of Cardiology Nihon University Hospital Tokyo Japan
- Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine Advanced Medical Emergency Department and Critical Care Center Japan Red Cross Maebashi Hospital Maebashi Japan
- Tomoya Okazaki
- Department of Emergency, Disaster and Critical Care Medicine Kagawa University Hospital Kagawa Japan
- Shinichi Ijuin
- Department of Emergency and Critical Care Medicine Hyogo Emergency Medical Center Kobe Japan
- Ryosuke Zushi
- Emergency Medicine Osaka Mishima Emergency and Critical Care Center Takatsuki Japan
- Hideki Arimoto
- Emergency and Critical Care Medical Center Osaka City General Hospital Osaka Japan
- Hiroaki Takada
- Department of Critical Care Medicine and Trauma National Hospital Organization Disaster Medical Center Tokyo Japan
- Shinichirou Shiraishi
- Department of Emergency and Critical Care Medicine Aizu Central Hospital Fukushima Japan
- Yuko Egawa
- Advanced Emergency and Critical Care Center Saitama Red Cross Hospital Saitama Japan
- Jun Kanda
- Trauma and Resuscitation Center Teikyo University Hospital Tokyo Japan
- Michitaka Nasu
- Department of Emergency and Critical Care Medicine Urasoe General Hospital Okinawa Japan
- Makoto Kobayashi
- Tajima Emergency and Critical Care Medical Center Toyooka Hospital Hyogo Japan
- Masaaki Sakuraya
- Department of Emergency and Intensive Care Medicine JA Hiroshima General Hospital Hiroshima Japan
- Hiromichi Naito
- Advanced Emergency and Critical Care Medical Center Okayama University Hospital Okayama Japan
- Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Osaka Japan
- Norio Otani
- Department of Emergency and Critical Care Medicine St. Luke’s International Hospital Tokyo Japan
- Ichiro Takeuchi
- Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan
- Naofumi Bunya
- Department of Emergency Medicine Sapporo Medical University Hokkaido Japan
- Takafumi Shimizu
- Emergency and Critical Care Medical Center Teine Keijinkai Hospital Hokkaido Japan
- Hirotaka Sawano
- Senri Critical Care Medical Center Saiseikai Senri Hospital Suita Japan
- Wataru Takayama
- Trauma and Acute Critical Care Medical Center Tokyo Medical and Dental University Hospital of Medicine Tokyo Japan
- Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
- Tomohisa Shoko
- Department of Emergency and Critical Care Medicine Tokyo Women's Medical University Medical Center East Tokyo Japan
- Makoto Aoki
- Department of Emergency Medicine Gunma University Graduate School of Medicine Maebashi Japan
- Takayuki Otani
- Department of Emergency Medicine Hiroshima Citizens Hospital Hiroshima Japan
- Yoshinori Matsuoka
- Department of Emergency Medicine Kobe City Medical Center General Hospital Kobe Japan
- Koichiro Homma
- Department of Emergency and Critical Care Medicine Keio University School of Medicine Tokyo Japan
- Kunihiko Maekawa
- Emergency and Critical Care Center Hokkaido University Hospital Sapporo Japan
- Yoshio Tahara
- Division of Cardiovascular Care Unit Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
- Reo Fukuda
- Department of Emergency and Critical Care Medicine Nippon Medical School Tama Nagayama Hospital Tokyo Japan
- Migaku Kikuchi
- Emergency and Critical Care Center Dokkyo Medical University Tochigi Japan
- Takuo Nakagami
- Department of Cardiovascular Medicine Omihachiman Community Medical Center Shiga Japan
- Yoshihiro Hagiwara
- Department of Emergency Medicine and Critical Care Medicine Tochigi Emergency and Critical Care Center Imperial Foundation Saiseikai Utsunomiya Hospital Tochigi Japan
- Nobuya Kitamura
- Department of Emergency and Critical Care Medicine Kimitsu Chuo Hospital Chiba Japan
- Kazuhiro Sugiyama
- Tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital Tokyo Japan
- Tetsuya Sakamoto
- Trauma and Resuscitation Center Teikyo University Hospital Tokyo Japan
- Yasuhiro Kuroda
- Department of Emergency, Disaster and Critical Care Medicine Kagawa University Hospital Kagawa Japan
- SAVE‐J II Study Group
- DOI
- https://doi.org/10.1002/ams2.647
- Journal volume & issue
-
Vol. 8,
no. 1
pp. n/a – n/a
Abstract
Aim A lack of known guidelines for the provision of extracorporeal cardiopulmonary resuscitation (ECPR) to patients with out‐of‐hospital cardiac arrest (OHCA) has led to variability in practice between hospitals even in the same country. Because variability in ECPR practice has not been completely examined, we aimed to describe the variability in ECPR practice in patients with OHCA from the emergency department (ED) to the intensive care units (ICU). Methods An anonymous online questionnaire to examine variability in ECPR practice was completed in January 2020 by 36 medical institutions who participated in the SAVE‐J II study. Institutional demographics, inclusion and exclusion criteria, initial resuscitation management, extracorporeal membrane oxygenation (ECMO) initiation, initial ECMO management, intra‐aortic balloon pumping/endotracheal intubation/management during coronary angiography, and computed tomography criteria were recorded. Results We received responses from all 36 institutions. Four institutions (11.1%) had a hybrid emergency room. Cardiovascular surgery was always involved throughout the entire ECMO process in only 14.7% of institutions; 60% of institutions had formal inclusion criteria and 50% had formal exclusion criteria. In two‐thirds of institutions, emergency physicians carried out cannulation. Catheterization room was the leading location of cannulation (48.6%) followed by ED (31.4%). The presence of formal exclusion criteria significantly increased with increasing ECPR volume (P for trend <0.001). Intra‐aortic balloon pumping was routinely initiated in only 25% of institutions. Computed tomography was routinely carried out before coronary angiography in 25% of institutions. Conclusions We described the variability in ECPR practice in patients with OHCA from the ED to the ICU.
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