Variability of extracorporeal cardiopulmonary resuscitation practice in patients with out-of-hospital cardiac arrest from the emergency department to intensive care unit in Japan

被引：25

作者：

Hifumi, Toru ^{[1
]}

Inoue, Akihiko ^{[2
]}

Takiguchi, Toru ^{[3
]}

Watanabe, Kazuhiro ^{[4
]}

Ogura, Takayuki ^{[5
,6
]}

Okazaki, Tomoya ^{[7
]}

Ijuin, Shinichi ^{[2
]}

Zushi, Ryosuke ^{[8
]}

Arimoto, Hideki ^{[9
]}

Takada, Hiroaki ^{[10
]}

Shiraishi, Shinichirou ^{[11
]}

Egawa, Yuko ^{[12
]}

Kanda, Jun ^{[13
]}

Nasu, Michitaka ^{[14
]}

Kobayashi, Makoto ^{[15
]}

Sakuraya, Masaaki ^{[16
]}

Naito, Hiromichi ^{[17
]}

Nakao, Shunichiro ^{[18
]}

Otani, Norio ^{[1
]}

Takeuchi, Ichiro ^{[19
]}

Bunya, Naofumi ^{[20
]}

Shimizu, Takafumi ^{[21
]}

Sawano, Hirotaka ^{[22
]}

Takayama, Wataru ^{[23
]}

Kushimoto, Shigeki ^{[24
]}

Shoko, Tomohisa ^{[25
]}

Aoki, Makoto ^{[26
]}

Otani, Takayuki ^{[27
]}

Matsuoka, Yoshinori ^{[28
]}

Homma, Koichiro ^{[29
]}

Maekawa, Kunihiko ^{[30
]}

Tahara, Yoshio ^{[31
]}

Fukuda, Reo ^{[32
]}

Kikuchi, Migaku ^{[33
]}

Nakagami, Takuo ^{[34
]}

Hagiwara, Yoshihiro ^{[35
]}

Kitamura, Nobuya ^{[36
]}

Sugiyama, Kazuhiro ^{[37
]}

Sakamoto, Tetsuya ^{[13
]}

Kuroda, Yasuhiro ^{[7
]}

机构：

[1] St Lukes Int Hosp, Dept Emergency & Crit Care Med, Tokyo, Japan

[2] Hyogo Emergency Med Ctr, Dept Emergency & Crit Care Med, Kobe, Hyogo, Japan

[3] Nippon Med Sch, Dept Emergency & Crit Care Med, Tokyo, Japan

[4] Nihon Univ Hosp, Dept Cardiol, Tokyo, Japan

[5] Japan Red Cross Maebashi Hosp, Dept Emergency Med & Crit Care Med, Adv Med Emergency Dept, Maebashi, Gumma, Japan

[6] Japan Red Cross Maebashi Hosp, Crit Care Ctr, Maebashi, Gumma, Japan

[7] Kagawa Univ Hosp, Dept Emergency Disaster & Crit Care Med, Miki, Kagawa, Japan

[8] Osaka Mishima Emergency & Crit Care Ctr, Emergency Med, Takatsuki, Osaka, Japan

[9] Osaka City Gen Hosp, Emergency & Crit Care Med Ctr, Osaka, Japan

[10] Natl Hosp Org Disaster Med Ctr, Dept Crit Care Med & Trauma, Tokyo, Japan

[11] Aizu Cent Hosp, Dept Emergency & Crit Care Med, Fukushima, Japan

[12] Saitama Red Cross Hosp, Adv Emergency & Crit Care Ctr, Saitama, Japan

[13] Teikyo Univ Hosp, Trauma & Resuscitat Ctr, Tokyo, Japan

[14] Urasoe Gen Hosp, Dept Emergency & Crit Care Med, Okinawa, Japan

[15] Toyooka Hosp, Tajima Emergency & Crit Care Med Ctr, Toyooka, Hyogo, Japan

[16] JA Hiroshima Gen Hosp, Dept Emergency & Intens Care Med, Hiroshima, Japan

[17] Okayama Univ Hosp, Adv Emergency & Crit Care Med Ctr, Okayama, Japan

[18] Osaka Univ, Dept Traumatol & Acute Crit Med, Grad Sch Med, Osaka, Japan

[19] Yokohama City Univ, Adv Crit Care & Emergency Ctr, Med Ctr, Yokohama, Kanagawa, Japan

[20] Sapporo Med Univ, Dept Emergency Med, Sapporo, Hokkaido, Japan

[21] Teine Keijinkai Hosp, Emergency & Crit Care Med Ctr, Sapporo, Hokkaido, Japan

[22] Saiseikai Senri Hosp, Senri Crit Care Med Ctr, Suita, Osaka, Japan

[23] Tokyo Med & Dent Univ, Trauma & Acute Crit Care Med Ctr, Hosp Med, Tokyo, Japan

[24] Tohoku Univ, Div Emergency & Crit Care Med, Grad Sch Med, Sendai, Miyagi, Japan

[25] Tokyo Womens Med Univ, Dept Emergency & Crit Care Med, Med Ctr East, Tokyo, Japan

[26] Gunma Univ, Dept Emergency Med, Grad Sch Med, Maebashi, Gumma, Japan

[27] Hiroshima Citizens Hosp, Dept Emergency Med, Hiroshima, Japan

[28] Kobe City Med Ctr Gen Hosp, Dept Emergency Med, Kobe, Hyogo, Japan

[29] Keio Univ, Dept Emergency & Crit Care Med, Sch Med, Tokyo, Japan

[30] Hokkaido Univ Hosp, Emergency & Crit Care Ctr, Sapporo, Hokkaido, Japan

[31] Natl Cerebral & Cardiovasc Ctr, Div Cardiovasc Care Unit, Dept Cardiovasc Med, Suita, Osaka, Japan

[32] Tama Nagayama Hosp, Dept Emergency & Crit Care Med, Nippon Med Sch, Tokyo, Japan

[33] Dokkyo Med Univ, Emergency & Crit Care Ctr, Mibu, Tochigi, Japan

[34] Omihachiman Community Med Ctr, Dept Cardiovasc Med, Shiga, Japan

[35] Utsunomiya Hosp, Dept Emergency Med & Crit Care Med, Tochigi Emergency & Crit Care Ctr, Imperial Fdn Saiseikai, Utsunomiya, Tochigi, Japan

[36] Kimitsu Chuo Hosp, Dept Emergency & Crit Care Med, Chiba, Japan

[37] Tokyo Metropolitan Bokutoh Hosp, Tertiary Emergency Med Ctr, Tokyo, Japan

来源：

ACUTE MEDICINE & SURGERY | 2021年 / 8卷 / 01期

关键词：

Emergency department; extracorporeal cardiopulmonary resuscitation; out-of-hospital cardiac arrest; MEMBRANE-OXYGENATION; COMPUTED-TOMOGRAPHY; ADULTS;

D O I：

10.1002/ams2.647

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aim: A lack of known guidelines for the provision of extracorporeal cardiopulmonary resuscitation (ECPR) to patients with out-of-hospital cardiac arrest (OHCA) has led to variability in practice between hospitals even in the same country. Because variability in ECPR practice has not been completely examined, we aimed to describe the variability in ECPR practice in patients with OHCA from the emergency department (ED) to the intensive care units (ICU). Methods: An anonymous online questionnaire to examine variability in ECPR practice was completed in January 2020 by 36 medical institutions who participated in the SAVE-J II study. Institutional demographics, inclusion and exclusion criteria, initial resuscitation management, extracorporeal membrane oxygenation (ECMO) initiation, initial ECMO management, intra-aortic balloon pumping/endotracheal intubation/management during coronary angiography, and computed tomography criteria were recorded. Results: We received responses from all 36 institutions. Four institutions (11.1%) had a hybrid emergency room. Cardiovascular surgery was always involved throughout the entire ECMO process in only 14.7% of institutions; 60% of institutions had formal inclusion criteria and 50% had formal exclusion criteria. In two-thirds of institutions, emergency physicians carried out cannulation. Catheterization room was the leading location of cannulation (48.6%) followed by ED (31.4%). The presence of formal exclusion criteria significantly increased with increasing ECPR volume (P for trend <0.001). Intra-aortic balloon pumping was routinely initiated in only 25% of institutions. Computed tomography was routinely carried out before coronary angiography in 25% of institutions. Conclusions: We described the variability in ECPR practice in patients with OHCA from the ED to the ICU.

引用

页数：10

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