Abstract P95: Impact of Percutaneous Cardiopulmonary Assisted Devices and Mild Hypothermia Therapy for Out-of-Hospital Cardiac Arrest in Patients From Multicenter Hypothermia Registry in Japan: J-PULSE- Hypo Registry
[Background] Although it has been reported that therapeutic hypothermia (TH) improves neurological outcomes of patients with out-of-hospital cardiac arrest, procedures of the hypothermia remain to be established. Particularly indications of TH for the patients with cardiogenic shock have not been sufficiently studied.
[Methods] Four years (2005–2008) data were available for the 281 patients treated with TH in the multicenter registry in Japan (J-Pulse-Hypo registry), for the purpose to investigate the efficacy of TH in out-of-hospital cardiac arrest patients. Selection of cooling procedure was left to each institution. The patients with hemodynamic compromised state were treated with percutaneous cardiopulmonary assisted devices (PCPS group). Primary end point of this study was favorable neurologic outcome (FNC), cerebral performance category (CPC) 1 and 2 rate at 30 days. We evaluated clinical characteristics of the patients treated with PCPS under TH, and factors to influence on FNC in patients treated with PCPS.
[Results] PCPS was used in 57/281 (20.3%) patients. To compare with non-PCPS group (n=224), there was no significant inter-group difference, in gender, the presence of bystanders, initial ECG findings but PCPS group showed less FNC rate at 30 days. Although PCPS group showed much hemodynamic compromised state, in rate of return of spontaneous circulation (ROSC) before admission, the collapse to ROSC interval, maximum blood pressure after ROSC, pH and base excess of arterial blood gas at presentation, PCPS group was more treated with percutaneous coronary intervention than in non-PCPS group.
[Conclusions] The patients treated with TH using PCPS, even who were in very ill condition, were reached FNC at 30 days up to 31.6%. This result may suggest that PSCS would be a therapeutic method to treat patients under metabolic phase after out-of-hospital cardiac arrest.