PMID- 24530251 OWN - NLM STAT- MEDLINE DCOM- 20150220 LR - 20220409 IS - 1873-1570 (Electronic) IS - 0300-9572 (Linking) VI - 85 IP - 6 DP - 2014 Jun TI - Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study. PG - 762-8 LID - S0300-9572(14)00065-3 [pii] LID - 10.1016/j.resuscitation.2014.01.031 [doi] AB - BACKGROUND: A favorable neurological outcome is likely to be achieved in out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation or pulseless ventricular tachycardia (VF/VT) on the initial electrocardiogram (ECG). However, in patients without pre-hospital restoration of spontaneous circulation despite the initial VF/VT, the outcome is extremely low by conventional cardiopulmonary resuscitation (CPR). Extracorporeal CPR (ECPR) may enhance cerebral blood flow and recovery of neurological function. We prospectively examined how ECPR for OHCA with VF/VT would affect neurological outcomes. METHODS AND RESULTS: The design of this trial was a prospective, observational study. We compared differences of outcome at 1 and 6 months after OHCA between ECPR group (26 hospitals) and non-ECPR group (20 hospitals). Primary endpoints were the rate of favorable outcomes defined by the Glasgow-Pittsburgh Cerebral Performance and Overall Performance Categories (CPC) 1 or 2 at 1 and 6 months after OHCA. Based on intention-to-treat analysis, CPC 1 or 2 were 12.3% (32/260) in the ECPR group and 1.5% (3/194) in the non-ECPR group at 1 month (P<0.0001), and 11.2% (29/260) and 2.6% (5/194) at 6 months (P=0.001), respectively. By per protocol analysis, CPC 1 or 2 were 13.7% (32/234) in the ECPR group and 1.9% (3/159) in the non-ECPR group at 1 month (P<0.0001), and 12.4% (29/234) and 3.1% (5/159) at 6 months (P=0.002), respectively. CONCLUSIONS: In OHCA patients with VF/VT on the initial ECG, a treatment bundle including ECPR, therapeutic hypothermia and IABP was associated with improved neurological outcome at 1 and 6 months after OHCA. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - Sakamoto, Tetsuya AU - Sakamoto T AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Morimura, Naoto AU - Morimura N AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. Electronic address: molimula@yokohama-cu.ac. FAU - Nagao, Ken AU - Nagao K AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Asai, Yasufumi AU - Asai Y AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Yokota, Hiroyuki AU - Yokota H AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Nara, Satoshi AU - Nara S AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Hase, Mamoru AU - Hase M AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Tahara, Yoshio AU - Tahara Y AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. FAU - Atsumi, Takahiro AU - Atsumi T AD - The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan. CN - SAVE-J Study Group LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20140212 PL - Ireland TA - Resuscitation JT - Resuscitation JID - 0332173 SB - IM CIN - Resuscitation. 2014 Jun;85(6):709-10. PMID: 24844727 MH - Adult MH - Cardiopulmonary Resuscitation/*methods MH - *Extracorporeal Membrane Oxygenation MH - Female MH - Humans MH - Male MH - Middle Aged MH - Out-of-Hospital Cardiac Arrest/*therapy MH - Prospective Studies OTO - NOTNLM OT - Advanced life support OT - Cardiopulmonary resuscitation OT - Extracorporeal cardiopulmonary resuscitation OT - Out-of-hospital cardiac arrest OT - Percutaneous cardiopulmonary support OT - Ventricular fibrillation FIR - Sakamoto, Tetsuya IR - Sakamoto T FIR - Morimura, Naoto IR - Morimura N FIR - Nagao, Ken IR - Nagao K FIR - Asai, Yasufumi IR - Asai Y FIR - Yokota, Hiroyuki IR - Yokota H FIR - Nara, Satoshi IR - Nara S FIR - Hase, Mamoru IR - Hase M FIR - Tahara, Yoshio IR - Tahara Y FIR - Atsumi, Takahiro IR - Atsumi T FIR - Kokubu, Nobuaki IR - Kokubu N FIR - Kozuma, Ken IR - Kozuma K FIR - Fukuda, Reo IR - Fukuda R FIR - Ueda, Takahiro IR - Ueda T FIR - Miyagi, Tadayoshi IR - Miyagi T FIR - Takahashi, Isao IR - Takahashi I FIR - Hayakawa, Mineji IR - Hayakawa M FIR - Endo, Tomoyuki IR - Endo T FIR - Tosa, Ryouichi IR - Tosa R FIR - Tagami, Takashi IR - Tagami T FIR - Mizutani, Taro IR - Mizutani T FIR - Yasuda, Susumu IR - Yasuda S FIR - Ano, Masaki IR - Ano M FIR - Ogino, Takashi IR - Ogino T FIR - Kiyota, Kazuya IR - Kiyota K FIR - Ono, Kazuyuki IR - Ono K FIR - Kikuchi, Migaku IR - Kikuchi M FIR - Matsushima, Hisao IR - Matsushima H FIR - Shinya, Kitamura IR - Shinya K FIR - Otani, Shunsuke IR - Otani S FIR - Watanabe, Kazuhiro IR - Watanabe K FIR - Hirose, Harumi IR - Hirose H FIR - Sasaki, Katsunori IR - Sasaki K FIR - Otomo, Yasuhiro IR - Otomo Y FIR - Seki, Yutaka IR - Seki Y FIR - Osawa, Makiko IR - Osawa M FIR - Takeda, Munekazu IR - Takeda M FIR - Yaguchi, Arino IR - Yaguchi A FIR - Morikawa, Kentarou IR - Morikawa K FIR - Miyake, Yasufumi IR - Miyake Y FIR - Kuno, Masamune IR - Kuno M FIR - Tanjoh, Katsuhisa IR - Tanjoh K FIR - Kinoshita, Kosaku IR - Kinoshita K FIR - Arai, Takao IR - Arai T FIR - Kumasaka, Kenichirou IR - Kumasaka K FIR - Hori, Shingo IR - Hori S FIR - Suzuki, Masaru IR - Suzuki M FIR - Sugita, Manabu IR - Sugita M FIR - Okubo, Hirokazu IR - Okubo H FIR - Sasaki, Jun IR - Sasaki J FIR - Watoh, Yukihiro IR - Watoh Y FIR - Matsuda, Kiyoshi IR - Matsuda K FIR - Kobayashi, Tatsuho IR - Kobayashi T FIR - Ogura, Shinji IR - Ogura S FIR - Ushikoshi, Hiroaki IR - Ushikoshi H FIR - Ojio, Shinsuke IR - Ojio S FIR - Maeda, Minoru IR - Maeda M FIR - Uzura, Masahiko IR - Uzura M FIR - Higashioka, Hiroaki IR - Higashioka H FIR - Yonemori, Terutake IR - Yonemori T FIR - Hattori, Tomonori IR - Hattori T FIR - Kitagawa, Yoshimi IR - Kitagawa Y FIR - Tsuboi, Shigeki IR - Tsuboi S FIR - Tatsukawa, Hirotaka IR - Tatsukawa H FIR - Sawano, Hirotaka IR - Sawano H FIR - Arimoto, Hideki IR - Arimoto H FIR - Ueda, Yasunori IR - Ueda Y FIR - Kashiwase, Kazunori IR - Kashiwase K FIR - Ukikusa, Minoru IR - Ukikusa M FIR - Hamasaki, Toshiaki IR - Hamasaki T FIR - Kozawa, Shuichi IR - Kozawa S FIR - Igarashi, Nobuaki IR - Igarashi N FIR - Sato, Junya IR - Sato J FIR - Ishii, Noboru IR - Ishii N FIR - Takahashi, Akira IR - Takahashi A FIR - Toyama, Kazunari IR - Toyama K FIR - Kotani, Joji IR - Kotani J FIR - Ishihara, Masaharu IR - Ishihara M FIR - Otani, Takayuki IR - Otani T FIR - Kasaoka, Shunji IR - Kasaoka S FIR - Suzuki, Makoto IR - Suzuki M FIR - Yamamoto, Yusuke IR - Yamamoto Y FIR - Osaka, Kumpei IR - Osaka K FIR - Yagi, Masaharu IR - Yagi M FIR - Kobashi, Shuichi IR - Kobashi S FIR - Momose, Naoki IR - Momose N FIR - Noguchi, Hiroyuki IR - Noguchi H FIR - Tamashiro, Satoshi IR - Tamashiro S FIR - Takahashi, Yoshinori IR - Takahashi Y FIR - Okawa, Osamu IR - Okawa O FIR - Matayoshi, Toru IR - Matayoshi T FIR - Miki, Takahiro IR - Miki T FIR - Kurashima, Naoki IR - Kurashima N FIR - Magata, Ken IR - Magata K FIR - Sugawara, Koji IR - Sugawara K FIR - Oshiyama, Takanori IR - Oshiyama T FIR - Tojo, Keiichi IR - Tojo K FIR - Koyama, Tomio IR - Koyama T FIR - Hayashi, Teruyuki IR - Hayashi T FIR - Ohhira, Junji IR - Ohhira J FIR - Araki, Yasuyuki IR - Araki Y EDAT- 2014/02/18 06:00 MHDA- 2015/02/24 06:00 CRDT- 2014/02/18 06:00 PHST- 2013/08/21 00:00 [received] PHST- 2014/01/27 00:00 [revised] PHST- 2014/01/30 00:00 [accepted] PHST- 2014/02/18 06:00 [entrez] PHST- 2014/02/18 06:00 [pubmed] PHST- 2015/02/24 06:00 [medline] AID - S0300-9572(14)00065-3 [pii] AID - 10.1016/j.resuscitation.2014.01.031 [doi] PST - ppublish SO - Resuscitation. 2014 Jun;85(6):762-8. doi: 10.1016/j.resuscitation.2014.01.031. Epub 2014 Feb 12.