Mechanical circulatory support for refractory out-of-hospital cardiac arrest:a Danish nationwide multicenter study
| العنوان: | Mechanical circulatory support for refractory out-of-hospital cardiac arrest:a Danish nationwide multicenter study |
|---|---|
| المؤلفون: | Lisette Okkels Jensen, Jesper Kjaergaard, Steffen Christensen, Louise Linde, Hans Eiskjær, Mariann Tang, Phillip Freeman, Carsten Stengaard, Sivagowry Rasalingam Mørk, Sisse Anette Thomassen, Jo Bønding Andreasen, Christian Juhl Terkelsen, Christian Hassager, Jacob E. Møller, Helle Laugesen, Peter Hasse Møller-Sørensen, Lars Riber, Henrik Schmidt, Emilie Gregers, Lene Holmvang, Jacob Greisen |
| المصدر: | Mørk, S R, Stengaard, C, Linde, L, Møller, J E, Jensen, L O, Schmidt, H, Riber, L P, Andreasen, J B, Thomassen, S A, Laugesen, H, Freeman, P M, Christensen, S, Greisen, J R, Tang, M, Møller-Sørensen, P H, Holmvang, L, Gregers, E, Kjaergaard, J, Hassager, C, Eiskjær, H & Terkelsen, C J 2021, ' Mechanical circulatory support for refractory out-of-hospital cardiac arrest : a Danish nationwide multicenter study ', Critical Care, vol. 25, no. 1, 174 . https://doi.org/10.1186/s13054-021-03606-5 Mørk, S R, Stengaard, C, Linde, L, Møller, J E, Jensen, L O, Schmidt, H, Riber, L P, Andreasen, J B, Thomassen, S A, Laugesen, H, Freeman, P M, Christensen, S, Greisen, J R, Tang, M, Møller-sørensen, P H, Holmvang, L, Gregers, E, Kjærgaard, J, Hassager, C, Eiskjær, H & Terkelsen, C J 2021, ' Mechanical circulatory support for refractory out-of-hospital cardiac arrest: a Danish nationwide multicenter study ', Critical Care, vol. 25, no. 1 . https://doi.org/10.1186/s13054-021-03606-5 Critical Care, Vol 25, Iss 1, Pp 1-13 (2021) Critical Care |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, Denmark, medicine.medical_treatment, Salvage therapy, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Logistic regression, Impella, Statistics, Nonparametric, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Mechanical circulatory support, medicine, Extracorporeal membrane oxygenation, Humans, Cardiopulmonary resuscitation, Survival rate, Survival analysis, Aged, Retrospective Studies, Aged, 80 and over, Out-of-hospital cardiac arrest, business.industry, RC86-88.9, Research, 030208 emergency & critical care medicine, Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, Logistic Models, Emergency medicine, Female, business, Cohort study |
| الوصف: | Background Mechanical circulatory support (MCS) with either extracorporeal membrane oxygenation or Impella has shown potential as a salvage therapy for patients with refractory out-of-hospital cardiac arrest (OHCA). The objective of this study was to describe the gradual implementation, survival and adherence to the national consensus with respect to use of MCS for OHCA in Denmark, and to identify factors associated with outcome. Methods This retrospective, observational cohort study included patients receiving MCS for OHCA at all tertiary cardiac arrest centers (n = 4) in Denmark between July 2011 and December 2020. Logistic regression and Kaplan–Meier survival analysis were used to determine association with outcome. Outcome was presented as survival to hospital discharge with good neurological outcome, 30-day survival and predictors of 30-day mortality. Results A total of 259 patients were included in the study. Thirty-day survival was 26%. Sixty-five (25%) survived to hospital discharge and a good neurological outcome (Glasgow–Pittsburgh Cerebral Performance Categories 1–2) was observed in 94% of these patients. Strict adherence to the national consensus showed a 30-day survival rate of 30% compared with 22% in patients violating one or more criteria. Adding criteria to the national consensus such as signs of life during cardiopulmonary resuscitation (CPR), pre-hospital low-flow 6.8 and lactate 15 mmol/L (RR 1.16, 95% CI 1.16–1.53) as factors associated with increased risk of 30-day mortality. Patients presenting signs of life during CPR had reduced risk of 30-day mortality (RR 0.63, 95% CI 0.52–0.76). Conclusions A high survival rate with a good neurological outcome was observed in this Danish population of patients treated with MCS for OHCA. Stringent patient selection for MCS may produce higher survival rates but potentially withholds life-saving treatment in a significant proportion of survivors. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::61b8f5ae821b4fd7c241d97e9c378acb https://pure.au.dk/portal/da/publications/mechanical-circulatory-support-for-refractory-outofhospital-cardiac-arrest(0b857604-e882-4271-8b44-16ab5e4d919f).html |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....61b8f5ae821b4fd7c241d97e9c378acb |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |