Abstract 128: Does Extracorporeal Cardiopulmonary Resuscitation Improve the Short- and Long-Term Outcome of Out-of Hospital Cardiac Arrest? Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J)
Background: The aim of this study is to confirm whether extracorporeal cardiopulmonary resuscitation (ECPR) improves the short and long term outcome about out-of hospital cardiac arrest (OHCA) with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).
Method: The design of this study is a multicenter non-randomized prospective cohort study. From Oct. 2008 to Sep. 2011, 46 tertiary emergency hospitals were participated in this study. Patient inclusion criteria were 1) VF or pulseless VT on scene, 2) cardiac arrest on arrival at hospital, 3) within 45 minutes from a call to an arrival of hospital, and 4) non-ROSC (return of spontaneous circulation) by conventional advanced life support (ALS) during 15 minutes after an arrival at hospital. Exclusion criteria were 1) age: <19 or >75 yr, 2) poor activities of daily livings, 3) non-cardiac verified cardiac arrest, and 4) cardiac arrest due to accidental hypothermia. According to the inclusion criteria, ECPR was intended to adopt for OHCA in 26 hospitals (ECPR group) and conventional ALS was continued essentially in 20 hospitals (non-ECPR group). Both groups were analyzed about the proportion of patients with favorable outcome (CPC1 or 2) assessed with the Glasgow-Pittsburgh Cerebral Performance and Overall Performance Categories at 1 month and 6 months by chi square test and Fisher exact probability test.
Results: 253 patients of ECPR group and 175 patients of non-ECPR group were enrolled. There was no difference between the background of ECPR group and non-ECPR group. The favorable outcome rate at 1 month in ECPR group (11.9%, 30 patients) was statistically higher than the rate in non-ECPR group (1.1%, 2 patients) (p<0.01) and at 6 months in ECPR group (9.9%, 25 patients) was also statistically higher than the rate in non-ECPR group (2.3%, 4 patients) (p<0.01). According to the follow up evaluation by questionnaire, 15 patients in ECPR group and 1 patient in non-ECPR group were confirmed to return to their former occupations.
Conclusion: Extracorporeal cardiopulmonary resuscitation improved the short and long term outcome of out-of hospital cardiac arrest with VF or pulseless VT without ROSC by conventional ALS during 15 minutes after an arrival at hospital.
- Extracorporeal circulation
- Cardiac arrest
- Ventricular fibrillation
- Cardiopulmonary resuscitation
- © 2012 by American Heart Association, Inc.