Optimal chest compression for cardiac arrest until the establishment of ECPR : Secondary analysis of the SAVE-J II study

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..

INTRODUCTION: The widespread incorporation of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest requires the delivery of effective and high-quality chest compressions prior to the initiation of ECPR. The aim of this study was to evaluate and compare the effectiveness of mechanical and manual chest compressions until the initiation of ECPR.

METHODS: This study was a secondary analysis of the Japanese retrospective multicenter registry "Study of Advanced Life Support for Ventricular Fibrillation by Extracorporeal Circulation II (SAVE-J II)". Patients were divided into two groups, one receiving mechanical chest compressions and the other receiving manual chest compressions. The primary outcome measure was mortality at hospital discharge, while the secondary outcome was the cerebral performance category (CPC) score at discharge.

RESULTS: Of the 2157 patients enrolled in the SAVE-J II trial, 453 patients (329 in the manual compression group and 124 in the mechanical compression group) were included in the final analysis. Univariate analysis showed a significantly higher mortality rate at hospital discharge in the mechanical compression group compared to the manual compression group (odds ratio [95% CI] = 2.32 [1.34-4.02], p = 0.0026). Multivariate analysis showed that mechanical chest compressions were an independent factor associated with increased mortality at hospital discharge (adjusted odds ratio [95% CI] = 2.00 [1.11-3.58], p = 0.02). There was no statistically significant difference in CPC between the two groups.

CONCLUSION: For patients with out-of-hospital cardiopulmonary arrest who require ECPR, extreme caution should be used when performing mechanical chest compressions.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:78

Enthalten in:

The American journal of emergency medicine - 78(2024) vom: 31. März, Seite 102-111

Sprache:

Englisch

Beteiligte Personen:

Nagashima, Futoshi [VerfasserIn]
Inoue, Satoshi [VerfasserIn]
Oda, Tomohiro [VerfasserIn]
Hamagami, Tomohiro [VerfasserIn]
Matsuda, Tomoya [VerfasserIn]
Kobayashi, Makoto [VerfasserIn]
Inoue, Akihiko [VerfasserIn]
Hifumi, Toru [VerfasserIn]
Sakamoto, Tetsuya [VerfasserIn]
Kuroda, Yasuhiro [VerfasserIn]
SAVE-J II study group [VerfasserIn]

Links:

Volltext

Themen:

Cerebral performance category (CPC)
Discharge mortality
Extracorporeal cardiopulmonary resuscitation (ECPR)
Journal Article
Manual chest compressions
Mechanical chest compressions
Multicenter Study
Out-of-hospital cardiac arrest

Anmerkungen:

Date Completed 25.03.2024

Date Revised 26.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ajem.2024.01.013

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367347350