Extracorporeal Life-support for Out-of-hospital Cardiac Arrest: A Nationwide Multicenter Study
Despite potential clinical roles of extracorporeal life support (ECLS) for out-of-hospital cardiac arrest (OHCA) compared to that of conventional cardiopulmonary resuscitation (CCPR), use of ECLS for OHCA is not strongly endorsed by current clinical guidelines. The purpose of this study is to invest...
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| Veröffentlicht in: | Shock (Augusta, Ga.) Ga.), 2022-05, Vol.57 (5), p.680-686 |
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| creator | Jeong, Daun Lee, Gun Tak Park, Jong Eun Chang, Hansol Kim, Taerim Cha, Won Chul Yoon, Hee Hwang, Sung Yeon Shin, Tae Gun Sim, Min Sub Jo, IkJoon Lee, Seung-Hwa Shin, Sang Do Choi, Jin-Ho |
| description | Despite potential clinical roles of extracorporeal life support (ECLS) for out-of-hospital cardiac arrest (OHCA) compared to that of conventional cardiopulmonary resuscitation (CCPR), use of ECLS for OHCA is not strongly endorsed by current clinical guidelines.
The purpose of this study is to investigate the clinical roles of extracorporeal life support (ECLS) compared with that of conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA) patients.
The outcomes of OHCA between 2015 and 2020, enrolled in the Korean Cardiac Arrest Research Consortium (KoCARC), a multicenter OHCA patient registry including 65 participating hospitals throughout the Republic of Korea (ClinicalTrials.gov, number NCT03222999). Differences in clinical features were adjusted by matching the propensity for ECLS. The primary outcome was 30-day neurologically favorable survival with cerebral performance category of 1 or 2. Restricted mean survival time (RMST) was used to compare outcomes between groups.
Of 12,006 patients included, ECLS was applied to 272 patients (2.2%). The frequency of neurologically favorable survival was higher in the ECLS group than the CCPR group (RMST difference, 5.5 days [95% CI, 4.1-7.0 days], P |
| doi_str_mv | 10.1097/SHK.0000000000001924 |
| format | Article |
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The purpose of this study is to investigate the clinical roles of extracorporeal life support (ECLS) compared with that of conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA) patients.
The outcomes of OHCA between 2015 and 2020, enrolled in the Korean Cardiac Arrest Research Consortium (KoCARC), a multicenter OHCA patient registry including 65 participating hospitals throughout the Republic of Korea (ClinicalTrials.gov, number NCT03222999). Differences in clinical features were adjusted by matching the propensity for ECLS. The primary outcome was 30-day neurologically favorable survival with cerebral performance category of 1 or 2. Restricted mean survival time (RMST) was used to compare outcomes between groups.
Of 12,006 patients included, ECLS was applied to 272 patients (2.2%). The frequency of neurologically favorable survival was higher in the ECLS group than the CCPR group (RMST difference, 5.5 days [95% CI, 4.1-7.0 days], P < 0.001). In propensity score-matched 271 pairs, the clinical outcome of ECLS and CCPR did not differ to a statistically significant extent (RMST difference, 0.4 days [95% CI -1.6 to 2.5 days], P = 0.67). Subgroup analyses revealed that the clinical roles of ECLS was evident in patients with nonshockable rhythm or CPR time ≥20 min (RMST difference, 2.7 days [95% CI 0.5-4.8 days], P = 0.015), but not in patients without these features (RMST difference, -3.7 days [95% CI -7.6 to 0.2 days], P = 0.07).
In this real-world data analysis, ECLS compared to CCPR did not result in better overall clinical outcomes of OHCA. The clinical efficacy of ECLS may be limited to a subgroup of high-risk patients.</description><identifier>ISSN: 1073-2322</identifier><identifier>EISSN: 1540-0514</identifier><identifier>DOI: 10.1097/SHK.0000000000001924</identifier><identifier>PMID: 35271541</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Cardiopulmonary Resuscitation ; Extracorporeal Membrane Oxygenation ; Humans ; Out-of-Hospital Cardiac Arrest - therapy ; Registries ; Retrospective Studies ; Survival Rate</subject><ispartof>Shock (Augusta, Ga.), 2022-05, Vol.57 (5), p.680-686</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2022 by the Shock Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3529-1decefe4a2a3ba3ec861548d51d4f98c11faf7b973d4953078e38471a6b060173</citedby><cites>FETCH-LOGICAL-c3529-1decefe4a2a3ba3ec861548d51d4f98c11faf7b973d4953078e38471a6b060173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00024382-202205000-00009$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,776,780,4595,27901,27902,65206</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35271541$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jeong, Daun</creatorcontrib><creatorcontrib>Lee, Gun Tak</creatorcontrib><creatorcontrib>Park, Jong Eun</creatorcontrib><creatorcontrib>Chang, Hansol</creatorcontrib><creatorcontrib>Kim, Taerim</creatorcontrib><creatorcontrib>Cha, Won Chul</creatorcontrib><creatorcontrib>Yoon, Hee</creatorcontrib><creatorcontrib>Hwang, Sung Yeon</creatorcontrib><creatorcontrib>Shin, Tae Gun</creatorcontrib><creatorcontrib>Sim, Min Sub</creatorcontrib><creatorcontrib>Jo, IkJoon</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Shin, Sang Do</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><title>Extracorporeal Life-support for Out-of-hospital Cardiac Arrest: A Nationwide Multicenter Study</title><title>Shock (Augusta, Ga.)</title><addtitle>Shock</addtitle><description>Despite potential clinical roles of extracorporeal life support (ECLS) for out-of-hospital cardiac arrest (OHCA) compared to that of conventional cardiopulmonary resuscitation (CCPR), use of ECLS for OHCA is not strongly endorsed by current clinical guidelines.
The purpose of this study is to investigate the clinical roles of extracorporeal life support (ECLS) compared with that of conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA) patients.
The outcomes of OHCA between 2015 and 2020, enrolled in the Korean Cardiac Arrest Research Consortium (KoCARC), a multicenter OHCA patient registry including 65 participating hospitals throughout the Republic of Korea (ClinicalTrials.gov, number NCT03222999). Differences in clinical features were adjusted by matching the propensity for ECLS. The primary outcome was 30-day neurologically favorable survival with cerebral performance category of 1 or 2. Restricted mean survival time (RMST) was used to compare outcomes between groups.
Of 12,006 patients included, ECLS was applied to 272 patients (2.2%). The frequency of neurologically favorable survival was higher in the ECLS group than the CCPR group (RMST difference, 5.5 days [95% CI, 4.1-7.0 days], P < 0.001). In propensity score-matched 271 pairs, the clinical outcome of ECLS and CCPR did not differ to a statistically significant extent (RMST difference, 0.4 days [95% CI -1.6 to 2.5 days], P = 0.67). Subgroup analyses revealed that the clinical roles of ECLS was evident in patients with nonshockable rhythm or CPR time ≥20 min (RMST difference, 2.7 days [95% CI 0.5-4.8 days], P = 0.015), but not in patients without these features (RMST difference, -3.7 days [95% CI -7.6 to 0.2 days], P = 0.07).
In this real-world data analysis, ECLS compared to CCPR did not result in better overall clinical outcomes of OHCA. The clinical efficacy of ECLS may be limited to a subgroup of high-risk patients.</description><subject>Cardiopulmonary Resuscitation</subject><subject>Extracorporeal Membrane Oxygenation</subject><subject>Humans</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><issn>1073-2322</issn><issn>1540-0514</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkElPwzAQhS0EomX5BwjlyMXFW-KEW1WVRRQ4AFcixxmrgbQOtqPCv8dVyyJ8GY_05s2bD6ETSkaUFPL88fp2RP48WjCxg4Y0FQSTlIrd-CeSY8YZG6AD718JYYIXch8NeMpkFNIhepl-BKe0dZ11oNpk1hjAvu9iGxJjXfLQB2wNnlvfNSEKJsrVjdLJ2Dnw4SIZJ_cqNHa5ampI7vo2NBqWAVzyGPr68wjtGdV6ON7WQ_R8OX2aXOPZw9XNZDzDOkYpMK1BgwGhmOKV4qDzLMbL65TWwhS5ptQoI6tC8loUKScyB54LSVVWkYxQyQ_R2ca3c_a9j8HKReM1tK1agu19yTKeS0YySaNUbKTaWe8dmLJzzUK5z5KSck22jGTL_2Tj2Ol2Q18toP4Z-kb567uybbzfv7X9Clw5j1TDfO0XTXKGGWGMpLHFa-uCfwE-xYNX</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Jeong, Daun</creator><creator>Lee, Gun Tak</creator><creator>Park, Jong Eun</creator><creator>Chang, Hansol</creator><creator>Kim, Taerim</creator><creator>Cha, Won Chul</creator><creator>Yoon, Hee</creator><creator>Hwang, Sung Yeon</creator><creator>Shin, Tae Gun</creator><creator>Sim, Min Sub</creator><creator>Jo, IkJoon</creator><creator>Lee, Seung-Hwa</creator><creator>Shin, Sang Do</creator><creator>Choi, Jin-Ho</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220501</creationdate><title>Extracorporeal Life-support for Out-of-hospital Cardiac Arrest: A Nationwide Multicenter Study</title><author>Jeong, Daun ; Lee, Gun Tak ; Park, Jong Eun ; Chang, Hansol ; Kim, Taerim ; Cha, Won Chul ; Yoon, Hee ; Hwang, Sung Yeon ; Shin, Tae Gun ; Sim, Min Sub ; Jo, IkJoon ; Lee, Seung-Hwa ; Shin, Sang Do ; Choi, Jin-Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3529-1decefe4a2a3ba3ec861548d51d4f98c11faf7b973d4953078e38471a6b060173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiopulmonary Resuscitation</topic><topic>Extracorporeal Membrane Oxygenation</topic><topic>Humans</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jeong, Daun</creatorcontrib><creatorcontrib>Lee, Gun Tak</creatorcontrib><creatorcontrib>Park, Jong Eun</creatorcontrib><creatorcontrib>Chang, Hansol</creatorcontrib><creatorcontrib>Kim, Taerim</creatorcontrib><creatorcontrib>Cha, Won Chul</creatorcontrib><creatorcontrib>Yoon, Hee</creatorcontrib><creatorcontrib>Hwang, Sung Yeon</creatorcontrib><creatorcontrib>Shin, Tae Gun</creatorcontrib><creatorcontrib>Sim, Min Sub</creatorcontrib><creatorcontrib>Jo, IkJoon</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Shin, Sang Do</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Shock (Augusta, Ga.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jeong, Daun</au><au>Lee, Gun Tak</au><au>Park, Jong Eun</au><au>Chang, Hansol</au><au>Kim, Taerim</au><au>Cha, Won Chul</au><au>Yoon, Hee</au><au>Hwang, Sung Yeon</au><au>Shin, Tae Gun</au><au>Sim, Min Sub</au><au>Jo, IkJoon</au><au>Lee, Seung-Hwa</au><au>Shin, Sang Do</au><au>Choi, Jin-Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracorporeal Life-support for Out-of-hospital Cardiac Arrest: A Nationwide Multicenter Study</atitle><jtitle>Shock (Augusta, Ga.)</jtitle><addtitle>Shock</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>57</volume><issue>5</issue><spage>680</spage><epage>686</epage><pages>680-686</pages><issn>1073-2322</issn><eissn>1540-0514</eissn><abstract>Despite potential clinical roles of extracorporeal life support (ECLS) for out-of-hospital cardiac arrest (OHCA) compared to that of conventional cardiopulmonary resuscitation (CCPR), use of ECLS for OHCA is not strongly endorsed by current clinical guidelines.
The purpose of this study is to investigate the clinical roles of extracorporeal life support (ECLS) compared with that of conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA) patients.
The outcomes of OHCA between 2015 and 2020, enrolled in the Korean Cardiac Arrest Research Consortium (KoCARC), a multicenter OHCA patient registry including 65 participating hospitals throughout the Republic of Korea (ClinicalTrials.gov, number NCT03222999). Differences in clinical features were adjusted by matching the propensity for ECLS. The primary outcome was 30-day neurologically favorable survival with cerebral performance category of 1 or 2. Restricted mean survival time (RMST) was used to compare outcomes between groups.
Of 12,006 patients included, ECLS was applied to 272 patients (2.2%). The frequency of neurologically favorable survival was higher in the ECLS group than the CCPR group (RMST difference, 5.5 days [95% CI, 4.1-7.0 days], P < 0.001). In propensity score-matched 271 pairs, the clinical outcome of ECLS and CCPR did not differ to a statistically significant extent (RMST difference, 0.4 days [95% CI -1.6 to 2.5 days], P = 0.67). Subgroup analyses revealed that the clinical roles of ECLS was evident in patients with nonshockable rhythm or CPR time ≥20 min (RMST difference, 2.7 days [95% CI 0.5-4.8 days], P = 0.015), but not in patients without these features (RMST difference, -3.7 days [95% CI -7.6 to 0.2 days], P = 0.07).
In this real-world data analysis, ECLS compared to CCPR did not result in better overall clinical outcomes of OHCA. The clinical efficacy of ECLS may be limited to a subgroup of high-risk patients.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>35271541</pmid><doi>10.1097/SHK.0000000000001924</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Cardiopulmonary Resuscitation Extracorporeal Membrane Oxygenation Humans Out-of-Hospital Cardiac Arrest - therapy Registries Retrospective Studies Survival Rate |
| title | Extracorporeal Life-support for Out-of-hospital Cardiac Arrest: A Nationwide Multicenter Study |
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