Revista Científica de la Sociedad Española de Medicina de Urgencias y Emergencias
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1er cuartil (5 de 32)
Emergency Medicine
Resumen
< ReturnAmbulance cardiopulmonary resuscitation: outcomes and associated factors in out-of-hospital cardiac arrest
Rosell Ortiz F, García del Águila J, Fernández del Valle P, Mellado-Vergel FJ, Vergara-Pérez S, Ruiz-Montero MR, Martínez-Lara M, Gómez-Jiménez FJ, González-Lobato I, García-Escudero G, Ruiz-Bailén M, Caballero García F, Caballero-García A, Vivar-Díaz I, Olavarría-Govantes L
Empresa Pública de Emergencias Sanitarias de Andalucía, Almería, Spain. Unidad de Investigación, Hospital Virgen del Rocío, Sevilla, Spain. Servicio de Urgencias, Hospital el Toyo, Almería, Spain. Facultad de Medicina, Universidad de Granada, Spain. Unidad de Cuidados Intensivos, Hospital de Linares, Jaén, Spain.
Objective. To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport.
Methods. Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non–heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance
CPR, survival, and neurologic outcome.
Results. Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91–10.76); P<.001)], witnessed
OHCA (OR, 1.62; 95% CI, 1.16–2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38–4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07–2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17–2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58–4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24–2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome.
Conclusions. Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance
CPR, a strategy that can be considered futile.
Methods. Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non–heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance
CPR, survival, and neurologic outcome.
Results. Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91–10.76); P<.001)], witnessed
OHCA (OR, 1.62; 95% CI, 1.16–2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38–4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07–2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17–2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58–4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24–2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome.
Conclusions. Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance
CPR, a strategy that can be considered futile.
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