Abstract 594: Clinical Characteristics of Patients with Neurologic Recovery after Out-of-Hospital Cardiac Arrest who Received Percutaneous Cardiopulmonary Support
Background: To our knowledge, no multicenter collaborative study has examined the characteristics of patients with neurologic recovery after percutaneous cardiopulmonary support (PCPS) for out-of-hospital cardiac arrest who did not respond to standard advanced cardiac life support.
Methods: We conducted a multicenter, retrospective, collaborative study at 5 critical care centers to examine the characteristics of patients with neurologic recovery after PCPS for out-of-hospital cardiac arrest diagnosed during the past year.
Results: PCPS was performed in 50 (4%) of 1220 patients in whom out-of-hospital cardiac arrest was diagnosed between January 2006 and December 2006. Their mean age was 52.8 ± 16.5 years. Men accounted for 84% of all patients. Bystanders performed cardiopulmonary resuscitation in 44% of witnessed cardiac arrests. The mean time from calls for emergency medical services to the initiation of PCPS was 60.0 ± 22.8 minutes. The mean duration of PCPS was 44.3 ± 51.2 hours. As for treatment regimens, mild hypothermia therapy was performed in 55% of the patients. In 23 patients with acute myocardial infarction, the success rate of coronary reperfusion after emergent percutaneous coronary intervention was 100%. The rate of favorable neurologic recovery was 12%. The rate of acute myocardial infarction (83% vs. 36%, p=0.03), the rate of gasping breathing on arrival (83% vs. 14%, p<0.01), the diameter of the pupils on arrival (3.3 ± 1.3 mm vs. 5.0 ± 1.4 mm, p<0.01), and the rate of ventricular fibrillation on electrocardiograms before PCPS (83% vs. 3%, p=0.02) differed significantly between patients who had neurologic recovery (N = 6) and those who did not (N = 44).
Conclusions: Our results suggested the clinical characteristics of patients associated with neurologic recovery in whom PCPS was effective for out-of-hospital cardiac arrest that did not respond to standard advanced cardiac life support. Further multicenter, collaborative studies are needed.