6533b834fe1ef96bd129cd66
RESEARCH PRODUCT
Prognostic factors for non-asphyxia-related cardiac arrest patients undergoing extracorporeal rewarming - HELP Registry Study
Tomasz RomaniukAnna Witt-majchrzakBeata HoreczyAleksandra KretPaweł PodsiadłoHubert HymczakTomasz CzarnikTomasz SanakTomasz DarochaWojciech DąbrowskiRomuald LangoRobert GałązkowskiMateusz PuśleckiJanusz SkalskiEwelina NowakSylweriusz KosińskiSzymon WaligórskiDominik DrobińskiMaciej PolakKrzysztof JarmoszewiczKrzysztof ToczekRafał DrwiłaBarbara Barteczko-grajekŁUkasz J. Krzychsubject
extracorporeal circulationmedicine.medical_specialtycardiac arrestHypothermia030204 cardiovascular system & hematologyhyperlactatemiaExtracorporeallaw.invention03 medical and health sciences0302 clinical medicine030202 anesthesiologylawHumansMedicineRegistriesRewarmingSurvival rateRetrospective StudiesUnivariate analysisbusiness.industryExtracorporeal circulationRetrospective cohort studyout-of-hospitalPrognosisIntensive care unitCardiopulmonary ResuscitationHeart ArrestCardiac surgeryAnesthesiology and Pain MedicineLife supportAnesthesiaPolandCardiology and Cardiovascular Medicinebusinessdescription
Objective: Extracorporeal rewarming is the treatment of choice for patients who had hypothermic cardiac arrest, allowing for best neurologic outcome. The authors’ goal was to identify factors associated with survival in nonasphyxia-related hypothermic cardiac arrest patients undergoing extracorporeal rewarming. Design: All 38 cardiac surgery departments in Poland were encouraged to report consecutive hypothermic cardiac arrest patients treated with extracorporeal life support. All variables collected were analyzed in order to compare survivor and nonsurvivor groups. The parameters available at the initiation of extracorporeal rewarming were considered as potential predictors of survival in a logistic regression model. The primary outcome was survival to discharge from the intensive care unit. The secondary outcome was neurologic status. Setting: Multicenter retrospective study. Participants: Ninety-eight cases in the final analysis. Interventions: All patients in nonasphyxia-related hypothermic cardiac arrest rewarmed with extracorporeal life support. Measurements and Main Results: The survival rate was 53.1%, and 94.2% of survivors had favorable neurologic outcome. The lowest reported core temperature with cerebral performance category scale 1 was 11.8°C. A univariate analysis identified 3 variables associated with survival, namely: age, initial arterial pH, and lactate concentration. In a multivariate analysis, 2 independent predictors of survival were age (0.957; 95% confidence interval [CI] 0.924-0.991) and lactates (0.871; 95% CI 0.789-0.961). The area under the receiver operating characteristics curve for this fitted model was 0.71; 95% CI 0.602-0.817. Conclusions: Favorable survival with good neurologic outcome in nonasphyxiated hypothermic patients treated with extracorporeal life support was reported. Age and initial lactate level are independently associated with survival.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |