Faster time to automated elevation of the head and thorax during cardiopulmonary resuscitation increases the probability of return of spontaneous circulation

被引:19
作者
Moore, Johanna C. [1 ]
Duval, Sue [2 ]
Lick, Charles [3 ]
Holley, Joseph [4 ]
Scheppke, Kenneth A. [5 ]
Salverda, Bayert [6 ]
Rojas-Salvador, Carolina [2 ]
Jacobs, Michael [7 ]
Nystrom, Paul [8 ]
Quinn, Ryan [9 ]
Adams, Paul J. [10 ]
Debaty, Guillaume P. [11 ]
Hutchison, Mack [12 ]
Mason, Charles [12 ]
Martinez, Eduardo [10 ]
Mason, Steven [10 ]
Clift, Armando [10 ]
Antevy, Peter [5 ]
Coyle, Charles [5 ]
Grizzard, Eric [13 ]
Garay, Sebastian [5 ]
Lurie, Keith G. [1 ]
Pepe, Paul E. [14 ]
机构
[1] Univ Minnesota, Hennepin Healthcare, Hennepin Healthcare Res Inst, Minneapolis, MN 55455 USA
[2] Univ Minnesota, Minneapolis, MN 55455 USA
[3] Allina EMS, Minneapolis, MN USA
[4] Tennessee Technol Univ, Cookeville, TN 38505 USA
[5] Palm Beach Cty Fire Rescue, Seattle, WA USA
[6] Hennepin Healthcare Res Inst, Washington, DC USA
[7] Alameda Cty EMS, Washington, DC USA
[8] Hennepin Healthcare, Edina Fire, Minneapolis, MN USA
[9] Edina Fire, Minneapolis, MN USA
[10] City Miami Fire Rescue, Miami, FL USA
[11] Univ Grenoble Alps, Grenoble, France
[12] Metropolitan EMS, Washington, DC USA
[13] Germantown Fire Dept, Seattle, WA USA
[14] Dallas Cty Fire Rescue, Seattle, WA USA
关键词
HOSPITAL CARDIAC-ARREST; CONTROLLED SEQUENTIAL ELEVATION; CEREBRAL PERFUSION; PORCINE MODEL; SWINE MODEL; UP CPR; SURVIVAL; OUTCOMES;
D O I
10.1016/j.resuscitation.2021.11.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Resuscitation in the Head Up position improves outcomes in animals treated with active compression decompression cardiopulmonary resuscitation and an impedance threshold device (ACD + ITD CPR). We assessed impact of time to deployment of an automated Head Up position (AHUP) based bundle of care after out-of-hospital cardiac arrest on return of spontaneous circulation (ROSC). Methods: Observational data were analyzed from a patient registry. Patients received treatment with 1) ACD + and/or automated CPR 2) an ITD and 3) an AHUP device. Probability of ROSC (ROSCprob) from the 9-1-1 call to AHUP device placement was assessed with a restricted cubic spline model and linear regression. Results: Of 11 sites, 6 recorded the interval from 9-1-1 to AHUP device (n = 227). ROSCprob for all rhythms was 34%(77/227). Median age (range) was 66 years (19-101) and 68% men. The ROSCprob for shockable rhythms was 47%(18/38). Minutes from 9-1-1 to AHUP device (median, range) varied between sites: 1) 6.4(4,15), 2) 8.0(5,19), 3) 9.9(4, 12), 4) 14.1(6, 36), 5) 15.9(6, 34), 6) 19.0(8, 38),(p = 0.0001). ROSCprob also varied; 1) 55.1%(16/29), 2) 60%(3/5), 3) 50%(3/6), 4) 22.7%(17/75), 5) 26.4%(9/34), and 6) 37.1%(29/78), (p = 0.019). For all rhythms between 4 and 12 min (n = 85), ROSCprob declined 5.6% for every minute elapsed (p = 0.024). For shockable rhythms, between 6 and 15 min (n = 23), ROSCprob de-clined 9.0% for every minute elapsed (p = 0.006). Conclusions: Faster time to deployment of an AHUP based bundle of care is associated with higher incidence of ROSC. This must be considered when evaluating and implementing this bundle.
引用
收藏
页码:63 / 69
页数:7
相关论文
共 20 条
[1]   Improved Survival After Out-of-Hospital Cardiac Arrest and Use of Automated External Defibrillators [J].
Blom, Marieke T. ;
Beesems, Stefanie G. ;
Homma, Petronella C. M. ;
Zijlstra, Jolande A. ;
Hulleman, Michiel ;
van Hoeijen, Daniel A. ;
Bardai, Abdennasser ;
Tijssen, Jan G. P. ;
Tan, Hanno L. ;
Koster, Rudolph W. .
CIRCULATION, 2014, 130 (21) :1868-+
[2]   Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic [J].
Chan, Paul S. ;
Girotra, Saket ;
Tang, Yuanyuan ;
Al-Araji, Rabab ;
Nallamothu, Brahmajee K. ;
McNally, Bryan .
JAMA CARDIOLOGY, 2021, 6 (03) :296-303
[3]   Tilting for perfusion: Head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest [J].
Debaty, Guillaume ;
Shin, Sang Do ;
Metzger, Anja ;
Kim, Taeyun ;
Ryu, Hyun Ho ;
Rees, Jennifer ;
McKnite, Scott ;
Matsuura, Timothy ;
Lick, Michael ;
Yannopoulos, Demetris ;
Lurie, Keith .
RESUSCITATION, 2015, 87 :38-43
[4]   Different Impacts of Time From Collapse to First Cardiopulmonary Resuscitation on Outcomes After Witnessed Out-of-Hospital Cardiac Arrest in Adults [J].
Hara, Masahiko ;
Hayashi, Kenichi ;
Hikoso, Shungo ;
Sakata, Yasushi ;
Kitamura, Tetsuhisa .
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2015, 8 (03) :277-284
[5]   Early Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest [J].
Hasselqvist-Ax, Ingela ;
Riva, Gabriel ;
Herlitz, Johan ;
Rosenqvist, Marten ;
Hollenberg, Jacob ;
Nordberg, Per ;
Ringh, Mattias ;
Jonsson, Martin ;
Axelsson, Christer ;
Lindqvist, Jonny ;
Karlsson, Thomas ;
Svensson, Leif .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (24) :2307-2315
[6]   Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden [J].
Holmberg, M ;
Holmberg, S ;
Herlitz, J .
RESUSCITATION, 2000, 47 (01) :59-70
[7]   Association Between Timeliness of Reperfusion Therapy and Clinical Outcomes in ST-Elevation Myocardial Infarction [J].
Lambert, Laurie ;
Brown, Kevin ;
Segal, Eli ;
Brophy, James ;
Rodes-Cabau, Josep ;
Bogaty, Peter .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 303 (21) :2148-2155
[8]   Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction [J].
McNamara, Robert L. ;
Wang, Yongfei ;
Herrin, Jeph ;
Curtis, Jeptha P. ;
Bradley, Elizabeth H. ;
Magid, David J. ;
Peterson, Eric D. ;
Blaney, Martha ;
Frederick, Paul D. ;
Krumholz, Harlan M. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 47 (11) :2180-2186
[9]   Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest [J].
Moore, Johanna C. ;
Salverda, Bayert ;
Rojas-Salvador, Carolina ;
Lick, Michael ;
Debaty, Guillaume ;
Lurie, Keith G. .
RESUSCITATION, 2021, 158 :220-227
[10]  
Moore JC, 2020, RESUSCITATION, V150, P23, DOI 10.1016/j.resuscitation.2020.02.023