Accredited cardiac arrest centers facilitate eCPR and improve neurological outcome

被引：14

作者：

Voss, Fabian ^{[2
]}

Thevathasan, Tharusan ^{[3
,4
]}

Scholz, Karl Heinrich ^{[5
]}

Boettiger, Bernd W. ^{[6
,7
]}

Scheiber, Daniel ^{[2
]}

Kabiri, Payam ^{[3
]}

Bernhard, Michael ^{[8
]}

Kienbaum, Peter ^{[9
]}

Jung, Christian ^{[2
]}

Westenfeld, Ralf ^{[1
,2
,10
]}

Skurk, Carsten ^{[3
]}

Adler, Christoph ^{[11
,12
]}

Kelm, Malte ^{[2
,13
]}

机构：

[1] Heinrich Heine Univ Dusseldorf, Dept Cardiol Pulmonol & Vasc Med, Moorenstr 5, D-40225 Dusseldorf, Germany

[2] Heinrich Heine Univ Dusseldorf, Med Fac, Div Cardiol Pulmonol & Vasc Med, Moorenstr 5, D-40225 Dusseldorf, Germany

[3] Charite Univ Med Berlin, Dept Cardiol Angiol & Intens Care Med, Deutsch Herzzentrum Charite, Campus Benjamin Franklin,Hindenburg Damm 30, D-12203 Berlin, Germany

[4] Berlin Inst Hlth, Anna Louisa Karsch Str 2, D-10178 Berlin, Germany

[5] Univ Med Ctr Gottingen UMG, Georg August Univ Gottingen, Dept Cardiol & Pneumol, Robert Koch Str 40, D-34075 Gottingen, Germany

[6] Univ Cologne, Fac Med, Kerpener Str 62, D-50937 Cologne, Germany

[7] Univ Cologne, Univ Hosp Cologne, Dept Anaesthesiol & Intens Care Med, Kerpener Str 62, D-50937 Cologne, Germany

[8] Univ Hosp, Heinrich Heine Univ, Med Fac, Emergency Dept, Dusseldorf, Germany

[9] Heinrich Heine Univ, Med Fac, Dept Anesthesiol, Dusseldorf, Germany

[10] Abiomed Europe GmbH Europe, Neunhofer Weg 3, D-52074 Aachen, Germany

[11] Univ Cologne, Fac Med, Dept Ophthalmol, Kerpener Str 62, D-50937 Cologne, Germany

[12] Univ Hosp Cologne, Dept Cardiol, Kerpener Str 62, D-50937 Cologne, Germany

[13] CARID Cardiovasc Res Inst Dusseldorf, Dusseldorf, Germany

来源：

RESUSCITATION | 2024年 / 194卷

关键词：

Out-of-hospital cardiac arrest; Cardiac arrest center; Outcomes; Extracorporeal cardio-pulmonary resuscitation; Veno-arterial extracorporeal membrane oxygenation; RESUSCITATION; SURVIVORS;

D O I：

10.1016/j.resuscitation.2023.110069

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome.Methods: A multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were com-pared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge.Results: In total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p = 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p < 0.05) increased after CAC accreditation. Likelihood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p < 0.01), whereas overall survival remained similar (35 vs. 35%, p > 0.99).Conclusion: CAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival.

引用

页数：5

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