The time-dependent yield of invasive vs. standard resuscitation strategies: A secondary analysis of the Prague out-of-hospital cardiac arrest study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F24%3A10488326" target="_blank" >RIV/00064165:_____/24:10488326 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/24:10488326

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=qmhXqa8pOG" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=qmhXqa8pOG</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.resuscitation.2024.110347" target="_blank" >10.1016/j.resuscitation.2024.110347</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The time-dependent yield of invasive vs. standard resuscitation strategies: A secondary analysis of the Prague out-of-hospital cardiac arrest study

Popis výsledku v původním jazyce

Background: It is unclear how invasive resuscitative protocols may impact the time-dependent prognosis of out-of-hospital cardiac arrest (OHCA) resuscitations, or the relationship between intra-arrest transport and outcomes. Methods: We performed a secondary analysis of the Prague OHCA Study, which randomized refractory OHCAs to &quot;invasive&quot; (intra-arrest transport for possible ECPR initiation) vs. &quot;standard&quot; resuscitation strategies (predominantly performed on-scene). Between groups, we compared outcomes of the initial resuscitation and 180- and 30-day favourable neurological outcomes (CPC 1-2), and within categories based on resuscitation duration (collapse-to-ROSC/ECPR interval). We plotted the dynamic probability of favourable outcomes with increasing durations of unsuccessful resuscitation. Results: Among invasive and standard groups, respectively: 34/124 (27%) vs. 58/132 (44%) had sustained ROSC (difference -17%, 95%CI -5.0, -28); 38/124 (31%) vs. 24/132 (18%) had 30-day favourable neurological outcomes (difference 12%; 95%CI 2.0, 23); and 39/124 (31%) vs. 29/132 (22%) had 180-day favourable neurological outcomes (difference 9.5%; 95%CI -1.3, 20). For favourable outcome cases: standard group resuscitation durations were right-skewed within the first 60 min; for the invasive group the distribution was bimodal, extending to 77 min. For invasive- and standard-treated cases, the probability of favourable outcomes among those in refractory arrest at 30 min was 28% and 7.6%, respectively; declining to 0% at 77 and 60 min. Conclusion: In comparison to standard resuscitation, invasive strategy cases had fewer achieve sustained ROSC, however improved overall 30-day favourable neurological outcomes. While standard resuscitation yield was limited to &lt; 60 min, invasive protocols offer a second extended window of potential successful resuscitation.

Název v anglickém jazyce

The time-dependent yield of invasive vs. standard resuscitation strategies: A secondary analysis of the Prague out-of-hospital cardiac arrest study

Popis výsledku anglicky

Background: It is unclear how invasive resuscitative protocols may impact the time-dependent prognosis of out-of-hospital cardiac arrest (OHCA) resuscitations, or the relationship between intra-arrest transport and outcomes. Methods: We performed a secondary analysis of the Prague OHCA Study, which randomized refractory OHCAs to &quot;invasive&quot; (intra-arrest transport for possible ECPR initiation) vs. &quot;standard&quot; resuscitation strategies (predominantly performed on-scene). Between groups, we compared outcomes of the initial resuscitation and 180- and 30-day favourable neurological outcomes (CPC 1-2), and within categories based on resuscitation duration (collapse-to-ROSC/ECPR interval). We plotted the dynamic probability of favourable outcomes with increasing durations of unsuccessful resuscitation. Results: Among invasive and standard groups, respectively: 34/124 (27%) vs. 58/132 (44%) had sustained ROSC (difference -17%, 95%CI -5.0, -28); 38/124 (31%) vs. 24/132 (18%) had 30-day favourable neurological outcomes (difference 12%; 95%CI 2.0, 23); and 39/124 (31%) vs. 29/132 (22%) had 180-day favourable neurological outcomes (difference 9.5%; 95%CI -1.3, 20). For favourable outcome cases: standard group resuscitation durations were right-skewed within the first 60 min; for the invasive group the distribution was bimodal, extending to 77 min. For invasive- and standard-treated cases, the probability of favourable outcomes among those in refractory arrest at 30 min was 28% and 7.6%, respectively; declining to 0% at 77 and 60 min. Conclusion: In comparison to standard resuscitation, invasive strategy cases had fewer achieve sustained ROSC, however improved overall 30-day favourable neurological outcomes. While standard resuscitation yield was limited to &lt; 60 min, invasive protocols offer a second extended window of potential successful resuscitation.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30223 - Anaesthesiology

Projekt

<a href="/cs/project/NT13225" target="_blank" >NT13225: Hyperinvazívní přístup k mimonemocniční zástavě srdce s použitím mechanizované masáže, přednemocničního chlazení, mimotělní podpory oběhu a časného invazívního vyšetření ve srovnání se standardní péčí. Randomizovaná srovnávací studie. "Prague OHCA study"</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Resuscitation

ISSN

0300-9572

e-ISSN

1873-1570

Svazek periodika

203

Číslo periodika v rámci svazku

October

Stát vydavatele periodika

IE - Irsko

Počet stran výsledku

9

Strana od-do

110347

Kód UT WoS článku

001334199100001

EID výsledku v databázi Scopus

2-s2.0-85201511731