Optimal cardiopulmonary resuscitation duration for favorable neurological outcomes after out-of-hospital cardiac arrest
- Authors
- Park, SungJoon; Lee, Sung Woo; Han, Kap Su; Lee, Eui Jung; Jang, Dong-Hyun; Lee, Si Jin; Lee, Ji Sung; Kim, Su Jin
- Issue Date
- 15-Jan-2022
- Publisher
- BMC
- Keywords
- Cardiac arrest; Cardiopulmonary resuscitation; Neurological outcome; Out-of-hospital cardiac arrest; Resuscitation
- Citation
- SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, v.30, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE
- Volume
- 30
- Number
- 1
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/138937
- DOI
- 10.1186/s13049-022-00993-8
- ISSN
- 1757-7241
- Abstract
- Background A favorable neurological outcome is closely related to patient characteristics and total cardiopulmonary resuscitation (CPR) duration. The total CPR duration consists of pre-hospital and in-hospital durations. To date, consensus is lacking on the optimal total CPR duration. Therefore, this study aimed to determine the upper limit of total CPR duration, the optimal cut-off time at the pre-hospital level, and the time to switch from conventional CPR to alternative CPR such as extracorporeal CPR. Methods We conducted a retrospective observational study using prospective, multi-center registry of out-of-hospital cardiac arrest (OHCA) patients between October 2015 and June 2019. Emergency medical service-assessed adult patients (aged >= 18 years) with non-traumatic OHCA were included. The primary endpoint was a favorable neurological outcome at hospital discharge. Results Among 7914 patients with OHCA, 577 had favorable neurological outcomes. The optimal cut-off for pre-hospital CPR duration in patients with OHCA was 12 min regardless of the initial rhythm. The optimal cut-offs for total CPR duration that transitioned from conventional CPR to an alternative CPR method were 25 and 21 min in patients with initial shockable and non-shockable rhythms, respectively. In the two groups, the upper limits of total CPR duration for achieving a probability of favorable neurological outcomes < 1% were 55-62 and 24-34 min, respectively, while those for a cumulative proportion of favorable neurological outcome > 99% were 43-53 and 45-71 min, respectively. Conclusions Herein, we identified the optimal cut-off time for transitioning from pre-hospital to in-hospital settings and from conventional CPR to alternative resuscitation. Although there is an upper limit of CPR duration, favorable neurological outcomes can be expected according to each patient's resuscitation-related factors, despite prolonged CPR duration.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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