背景:体外心肺复苏(ECPR)是常规心肺复苏(CCPR)后可逆性心脏骤停(CA)的患者的替代方法。然而,ECPR期间的心肺复苏(CPR)持续时间可能因多种因素而异。医疗保健提供者需要了解这些因素,以优化复苏过程并改善结果。这项研究的目的是检查影响接受ECPR的患者CPR持续时间的不同变量。
方法:本回顾性研究,单中心,观察性研究是在哈马德总医院(HGH)因院内CA(IHCA)或院外CA(OHCA)而接受ECPR的成年患者进行的,卡塔尔三级政府医院,2016年2月至2020年3月。进行了单变量和多变量二元逻辑回归分析,以确定与CPR持续时间相关的预后因素。包括人口统计学和临床变量,以及实验室测试。
结果:接受ECPR的48名参与者的平均±标准分组年龄为41.50±13.15岁,75%是男性。在77.1%和22.9%的病例中报告了OHCA和IHCA,分别。多变量分析显示,几个因素与CPR持续时间的增加显著相关:年龄(OR:1.981,95CI:1.021-3.364,P=0.025)。SOFA评分(OR:3.389,95CI:1.289-4.911,P=0.013),合并症的存在(OR:3.715,95CI:1.907-5.219,P=0.026),OHCA(OR:3.715,95CI:1.907-5.219,P=0.026),塌陷至CPR时间延长(OR:1.446,95CI:1.092-3.014,P=0.001)。此外,研究发现,初始可电击心律与CPR持续时间呈负相关(OR:0.271,95CI:0.161~0.922,P=0.045).然而,在实验室检查和CPR持续时间之间未发现显著关联.
结论:这些发现表明年龄,SOFA得分,合并症,OHCA,崩溃到心肺复苏的时间,和初始可电击心律是影响ECPR患者CPR持续时间的重要因素。了解这些因素可以帮助医疗保健提供者更好地预测和管理CPR持续时间。可能改善患者预后。需要进一步的研究来验证这些发现,并探索可能影响该人群CPR持续时间的其他因素。
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is an alternative method for patients with reversible causes of cardiac arrest (CA) after conventional cardiopulmonary resuscitation (CCPR). However, cardiopulmonary resuscitation (CPR) duration during ECPR can vary due to multiple factors. Healthcare providers need to understand these factors to optimize the resuscitation process and improve outcomes. The aim of this study was to examine the different variables impacting the duration of CPR in patients undergoing ECPR.
METHODS: This retrospective, single-center, observational study was conducted on adult patients who underwent ECPR due to in-hospital CA (IHCA) or out-of-hospital CA (OHCA) at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. Univariate and multivariate binary logistic regression analyses were performed to identify the prognostic factors associated with CPR duration, including demographic and clinical variables, as well as laboratory tests.
RESULTS: The mean ± standard division age of the 48 participants who underwent ECPR was 41.50 ± 13.15 years, and 75% being male. OHCA and IHCA were reported in 77.1% and 22.9% of the cases, respectively. The multivariate analysis revealed that several factors were significantly associated with an increased CPR duration: higher age (OR: 1.981, 95%CI: 1.021-3.364, P = 0.025), SOFA score (OR: 3.389, 95%CI: 1.289-4.911, P = 0.013), presence of comorbidities (OR: 3.715, 95%CI: 1.907-5.219, P = 0.026), OHCA (OR: 3.715, 95%CI: 1.907-5.219, P = 0.026), and prolonged collapse-to-CPR time (OR: 1.446, 95%CI:1.092-3.014, P = 0.001). Additionally, the study found that the initial shockable rhythm was inversely associated with the duration of CPR (OR: 0.271, 95%CI: 0.161-0.922, P = 0.045). However, no significant associations were found between laboratory tests and CPR duration.
CONCLUSIONS: These findings suggest that age, SOFA score, comorbidities, OHCA, collapse-to-CPR time, and initial shockable rhythm are important factors influencing the duration of CPR in patients undergoing ECPR. Understanding these factors can help healthcare providers better predict and manage CPR duration, potentially improving patient outcomes. Further research is warranted to validate these findings and explore additional factors that may impact CPR duration in this population.