Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan
Posted on 2020-05-12 - 03:39
Abstract Background We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875–7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10–0.63) and 0.24 (95% CI 0.09–0.61), respectively. Conclusions This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.
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Okada, Yohei; Kiguchi, Takeyuki; Irisawa, Taro; Yoshiya, Kazuhisa; Yamada, Tomoki; Hayakawa, Koichi; et al. (2020). Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.4972631.v1
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AUTHORS (27)
YO
Yohei Okada
TK
Takeyuki Kiguchi
TI
Taro Irisawa
KY
Kazuhisa Yoshiya
TY
Tomoki Yamada
KH
Koichi Hayakawa
KN
Kazuo Noguchi
TN
Tetsuro Nishimura
TI
Takuya Ishibe
YY
Yoshiki Yagi
MK
Masafumi Kishimoto
HS
Hiroshi Shintani
YH
Yasuyuki Hayashi
TS
Taku Sogabe
TM
Takaya Morooka
HS
Haruko Sakamoto
KS
Keitaro Suzuki
FN
Fumiko Nakamura
NN
Norihiro Nishioka
TM
Tasuku Matsuyama