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A concept for the development of a pioneer regional Out-of-Hospital Cardiac Arrest Program to improve patient outcomes
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Abstract
Background: Immediate initiation of cardiopulmonary resuscitation (CPR) increases chances of restoring spontaneous circulation and survival after out‑of‑hospital cardiac arrest (OHCA). For some refractory cases, extended cardiopulmonary resuscitation (ECPR) may be a promising option.
Aims: The aim of the study was to estimate the possibility of implementation of ECPR procedure to improve current early outcomes of patients after OHCA.
Methods: The medicalcharts of the Province Emergency Station in Poznań from a 12‑month periodwere assessed retrospectively. All OHCA cases were identified and the following potential inclusion criteria for ECPR were analyzed: initial defibrillation rhythm, age between 18 and 65 years, CPR conducted by bystanders, and time to hospital arrival less than 40 minutes.
Results: In 576 (46.7%) of 1233 identified OHCA cases, CPR wasinitiated by bystanders and automated external defibrillatorwas applied only 17 times. An initial defibrillation rhythm was noted in 138 individuals (11.2%). Out of 65 patients who met the ECPR age criterion, 55 underwent CPR by bystanders which lead to a no‑flow time that did not exceed 10 minutes. The additional 9 of them would be excluded due to time to hospital arrival. This means that ECPR would be applicable in 46 patients after OHCA.
Conclusions: Our analysis showed that in some patients after sudden cardiac arrest, it would have been possible to implement ECPR as a crucial part of the Regional Out-of-Hospital Cardiac Arrest (OHCA) Program, and in consequence, probably to improve early outcomes of patients with refractory and potentially reversible cardiac arrest.
Abstract
Background: Immediate initiation of cardiopulmonary resuscitation (CPR) increases chances of restoring spontaneous circulation and survival after out‑of‑hospital cardiac arrest (OHCA). For some refractory cases, extended cardiopulmonary resuscitation (ECPR) may be a promising option.
Aims: The aim of the study was to estimate the possibility of implementation of ECPR procedure to improve current early outcomes of patients after OHCA.
Methods: The medicalcharts of the Province Emergency Station in Poznań from a 12‑month periodwere assessed retrospectively. All OHCA cases were identified and the following potential inclusion criteria for ECPR were analyzed: initial defibrillation rhythm, age between 18 and 65 years, CPR conducted by bystanders, and time to hospital arrival less than 40 minutes.
Results: In 576 (46.7%) of 1233 identified OHCA cases, CPR wasinitiated by bystanders and automated external defibrillatorwas applied only 17 times. An initial defibrillation rhythm was noted in 138 individuals (11.2%). Out of 65 patients who met the ECPR age criterion, 55 underwent CPR by bystanders which lead to a no‑flow time that did not exceed 10 minutes. The additional 9 of them would be excluded due to time to hospital arrival. This means that ECPR would be applicable in 46 patients after OHCA.
Conclusions: Our analysis showed that in some patients after sudden cardiac arrest, it would have been possible to implement ECPR as a crucial part of the Regional Out-of-Hospital Cardiac Arrest (OHCA) Program, and in consequence, probably to improve early outcomes of patients with refractory and potentially reversible cardiac arrest.
About this articleTitle
A concept for the development of a pioneer regional Out-of-Hospital Cardiac Arrest Program to improve patient outcomes
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Pages
875-881
Published online
2020-06-16
Page views
177
Article views/downloads
203
DOI
10.33963/KP.15433
Pubmed
Bibliographic record
Kardiol Pol 2020;78(9):875-881.
Authors
Maciej Sip
Mateusz Puślecki
Tomasz Kłosiewicz
Radosław Zalewski
Marek Dąbrowski
Marcin Ligowski
Ewa Goszczyńska
Christopher Paprocki
Marek Grygier
Maciej Lesiak
Marek Jemielity
Bartłomiej Perek
