Abstract 141: Impact of Prehospital Advanced Care on Regional Brain Oxygen Saturation at Hospital Arrival and Neurological Outcomes at 90 Days in Patients with Out-of-Hospital Cardiopulmonary Arrest
Introduction: In recent years, brain resuscitation has gained importance over cardiopulmonary resuscitation for the prognosis of patients experiencing cardiac arrest.
Objective: The aim of this study was to investigate the impact of pre-hospital advanced care on the brain resuscitation after out-of-hospital cardiac arrest (OHCA).
Methods: The J-POP registry is a prospective multicenter cohort study to test whether regional brain oxygen saturation (rSO2) predicts neurological outcomes after non-traumatic OHCA, and we previously demonstrated good neurological outcomes were associated with high rSO2 (>40%) at hospital arrival.
From this database, the data on patients with ROSC at hospital arrival were analyzed. Primary endpoints were high rSO2 (>40%) at hospital arrival and good neurological outcomes (CPC 1 / 2) at 90 days.
Results: Of the 1921 OHCA patients included in the J-POP registry database, 148 patients with ROSC at hospital arrival were included in this study; of these, 109 (73%) had high rSO2 (>40%) at hospital arrival and 56 (38%) had good neurological outcomes (CPC 1 / 2) at 90 days.
Univariate and multivariate analyses demonstrated that pre-hospital defibrillation was significantly associated with high rSO2 at hospital arrival and positive neurological outcomes. However, pre-hospital intravenous epinephrine administration showed an inverse correlation with both the positive endpoints. Further, pre-hospital use of advanced airway devices showed a significant association with negative neurological outcomes (see table).
Conclusion: Pre-hospital defibrillation improved brain resuscitation after OHCA by restoring adequate cerebral tissue oxygenation. On the other hand, pre-hospital intravenous epinephrine administration showed an inverse relation with cerebral tissue oxygenation at hospital arrival and positive neurological prognosis.
Author Disclosures: H. Yasuda: None. K. Nishiyama: None. N. Ito: None. H. Arimoto: None. T. Orita: None. M. Akira: None. K. Okuchi: None. H. Anan: None. T. Hatada: None. S. Ishimatsu: None. M. Tokura: None. K. Shiga: None. S. Kushimoto: None. S. Hori: None.
- © 2014 by American Heart Association, Inc.