MISC

2015年9月10日

Subsequent shock deliveries are associated with increased favorable neurological outcomes in cardiac arrest patients who had initially non-shockable rhythms

Critical Care
  • Nobuya Kitamura
  • ,
  • and on behalf of the SOS-KANTO 2012 Study Group
  • ,
  • Taka-aki Nakada
  • ,
  • Koichiro Shinozaki
  • ,
  • Yoshio Tahara
  • ,
  • Atsushi Sakurai
  • ,
  • Naohiro Yonemoto
  • ,
  • Ken Nagao
  • ,
  • Arino Yaguchi
  • ,
  • Naoto Morimura
  • ,
  • Sadaki Inokuchi
  • ,
  • Yoshihiro Masui
  • ,
  • Kunihisa Miura
  • ,
  • Haruhiko Tsutsumi
  • ,
  • Kiyotsugu Takuma
  • ,
  • Ishihara Atsushi
  • ,
  • Minoru Nakano
  • ,
  • Hiroshi Tanaka
  • ,
  • Keiichi Ikegami
  • ,
  • Takao Arai
  • ,
  • Arino Yaguchi
  • ,
  • Nobuya Kitamura
  • ,
  • Shigeto Oda
  • ,
  • Kenji Kobayashi
  • ,
  • Takayuki Suda
  • ,
  • Kazuyuki Ono
  • ,
  • Naoto Morimura
  • ,
  • Ryosuke Furuya
  • ,
  • Yuichi Koido
  • ,
  • Fumiaki Iwase
  • ,
  • Ken Nagao
  • ,
  • Shigeru Kanesaka
  • ,
  • Yasusei Okada
  • ,
  • Kyoko Unemoto
  • ,
  • Tomohito Sadahiro
  • ,
  • Masayuki Iyanaga
  • ,
  • Asaki Muraoka
  • ,
  • Munehiro Hayashi
  • ,
  • Shinichi Ishimatsu
  • ,
  • Yasufumi Miyake
  • ,
  • Hideo Yokokawa
  • ,
  • Yasuaki Koyama
  • ,
  • Asuka Tsuchiya
  • ,
  • Tetsuya Kashiyama
  • ,
  • Munetaka Hayashi
  • ,
  • Kiyohiro Oshima
  • ,
  • Kazuya Kiyota
  • ,
  • Yuichi Hamabe
  • ,
  • Hiroyuki Yokota
  • ,
  • Shingo Hori
  • ,
  • Shin Inaba
  • ,
  • Tetsuya Sakamoto
  • ,
  • Naoshige Harada
  • ,
  • Akio Kimura
  • ,
  • Masayuki Kanai
  • ,
  • Yasuhiro Otomo
  • ,
  • Manabu Sugita
  • ,
  • Kosaku Kinoshita
  • ,
  • Takatoshi Sakurai
  • ,
  • Mitsuhide Kitano
  • ,
  • Kiyoshi Matsuda
  • ,
  • Kotaro Tanaka
  • ,
  • Katsunori Yoshihara
  • ,
  • Kikuo Yoh
  • ,
  • Junichi Suzuki
  • ,
  • Hiroshi Toyoda
  • ,
  • Kunihiro Mashiko
  • ,
  • Naoki Shimizu
  • ,
  • Takashi Muguruma
  • ,
  • Tadanaga Shimada
  • ,
  • Yoshiro Kobe
  • ,
  • Tomohisa Shoko
  • ,
  • Kazuya Nakanishi
  • ,
  • Takashi Muguruma
  • ,
  • Takefumi Yamamoto
  • ,
  • Kazuhiko Sekine
  • ,
  • Shinichi Izuka

19
1
記述言語
英語
掲載種別
DOI
10.1186/s13054-015-1028-0
出版者・発行元
BioMed Central Ltd.

Introduction: Previous studies evaluating whether subsequent conversion to shockable rhythms in patients who had initially non-shockable rhythms was associated with altered clinical outcome reported inconsistent results. Therefore, we hypothesized that subsequent shock delivery by emergency medical service (EMS) providers altered clinical outcomes in patients with initially non-shockable rhythms. Methods: We tested for an association between subsequent shock delivery in EMS resuscitation and clinical outcomes in patients with initially non-shockable rhythms (n = 11,481) through a survey of patients after out-of-hospital cardiac arrest in the Kanto region (SOS-KANTO) 2012 study cohort, Japan. The primary investigated outcome was 1-month survival with favorable neurological functions. The secondary outcome variable was the presence of subsequent shock delivery. We further evaluated the association of interval from initiation of cardiopulmonary resuscitation to shock with clinical outcomes. Results: In the univariate analysis of initially non-shockable rhythms, patients who received subsequent shock delivery had significantly increased frequency of return of spontaneous circulation, 24-hour survival, 1-month survival, and favorable neurological outcomes compared to the subsequent not shocked group (P &lt
0.0001). In the multivariate logistic regression analysis, subsequent shock was significantly associated with favorable neurological outcomes (vs. not shocked
adjusted P = 0.0020, odds ratio, 2.78
95 % confidence interval, 1.45-5.30). Younger age, witnessed arrest, initial pulseless electrical activity rhythms, and cardiac etiology were significantly associated with the presence of subsequent shock in patients with initially non-shockable rhythms. Conclusions: In this study of cardiac arrest patients with initially non-shockable rhythms, patients who received early defibrillation by EMS providers had increased 1-month favorable neurological outcomes.

リンク情報
DOI
https://doi.org/10.1186/s13054-015-1028-0
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26353809
URL
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84940981435&origin=inward
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84940981435&origin=inward 本文へのリンクあり
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84940981435&origin=inward
ID情報
  • DOI : 10.1186/s13054-015-1028-0
  • ISSN : 1466-609X
  • ISSN : 1364-8535
  • eISSN : 1466-609X
  • PubMed ID : 26353809
  • SCOPUS ID : 84940981435

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