Document Detail

Early defibrillation and circulatory support can provide better long-term outcomes through favorable neurological recovery in patients with out-of-hospital cardiac arrest of cardiac origin.
MedLine Citation:
PMID:  16247202     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Early defibrillation and cardiopulmonary bypass have been postulated to be a promising intervention against out-of-hospital cardiac arrest (OHCA); however, little is known about the long-term prognosis. The effects of early recovery of circulation (ROC) on neurological recovery and the long-term outcome in patients with OHCA were examined. METHODS AND RESULTS: Functional recovery and long-term (22.0+/-15.3 months) outcome were examined in 100 patients with definite diagnosis of OHCA. Spontaneous circulation recovered in 79% of the patients (using on-site counter shock in 20% of the patients). Cardiopulmonary bypass was performed in 38 of the OHCA patients. The total survival and favorable neurological recovery rates were 40% and 25%, respectively. The patients with favorable recovery obtained early ROC (28.2+/-16.0 min). Receiver-operating characteristic analysis showed that a period of less than 35 min for ROC was the optimal period for achieving a favorable recovery, with sensitivity of 68% and specificity of 73%. The patients with a prior history of heart failure or reduced left ventricular ejection fraction exhibited more frequent, exacerbated heart failure and ventricular arrhythmias. CONCLUSIONS: Early ROC using on-site counter shock or cardiopulmonary bypass might result in better long-term outcome in patients with OHCA of cardiac origin.
Mamoru Hase; Kazufumi Tsuchihashi; Noriyuki Fujii; Kimio Nishizato; Nobuaki Kokubu; Satoshi Nara; Yoshihiko Kurimoto; Akiyoshi Hashimoto; Kikuya Uno; Tetsuji Miura; Nobuyuki Ura; Yasufumi Asai; Kazuaki Shimamoto
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  69     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-25     Completed Date:  2006-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1302-7     Citation Subset:  IM    
Division of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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MeSH Terms
Cardiopulmonary Resuscitation* / methods
Defibrillators, Implantable*
Emergency Medical Services* / methods
Heart Arrest* / complications,  mortality,  therapy
Middle Aged
Nervous System Diseases* / etiology,  therapy
Recovery of Function*
Time Factors

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