Abstract P174: Systematic Literature Review: Out-of-hospital Cardiac Arrests With Extracorporeal Cardiopulmonary Resuscitation in Japan
Background: In addition to the literature review of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest in the 2008 Resuscitation Symposium, we collected and reviewed the report in Japan concerning ECPR for out-of-hospital cardiac arrest of recent one year.
Methods: Case report, case series, and abstract of scientific meeting of ECPR for out-of cardiac arrest written in Japanese between Jan 1983 and Aug 2008 were collected. The outcome and characteristics of patients were investigated, and the influence of publication bias of the case series study was examined by the Funnel Plot method. In-depth review was also conducted to the case of all case-report and the case with detailed description of clinical course of case-series to clarify the outcome and characteristics.
Results: There were 1282 out-of hospital cardiac arrest patients who received ECPR in 105 reports (including 62 case series and 43 case reports) during the period. The average age was 51 years old and 75.9% was male. Excluding accidental hypothermia cases, survival rate at discharge of 516 cases those were clearly described the outcome was 26.7±1.4%. When the relationship between the number of cases and the survival rate at discharge in each 44 case series study was shown in figure by the Funnel Plot method, the plotted data presented the reverse-funnel type that centered on the average of survival rate of all. In-depth review of 139 cases demonstrated that the cause of arrest was cardiac in 88 cases (63.3%). The rate of good recovery, moderately disabled, severely disabled, vegetative state, and dead at hospital discharge in total cases were 48.2%, 2.9%, 2.2%, 2.9%, 37.4%, respectively.
Conclusions: Based on the results with the low publication bias of previous reports in Japan, ECPR can provide high survival rate with excellent neurological outcome of out-of hospital cardiac arrest. Current multi-center large prospective trial, SAVE-J, will determine the efficacy.