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大学・研究所にある論文を検索できる 「Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

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Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan

Okada, Yohei 大阪大学

2020.05.11

概要

Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR).

Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival.

Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875-7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10-0.63) and 0.24 (95% CI 0.09-0.61), respectively.

Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.

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参考文献

1. Sakamoto T, Morimura N, Nagao K, Asai Y, Yokota H, Nara S, et al. Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study. Resuscitation. 2014;85:762–8.

2. Ortega-Deballon I, Hornby L, Shemie SD, Bhanji F, Guadagno E. Extracorporeal resuscitation for refractory out-of-hospital cardiac arrest in adults: a systematic review of international practices and outcomes. Resuscitation. 2016;101:12–20.

3. Yannopoulos D, Bartos JA, Raveendran G, Conterato M, Frascone RJ, Trembley A, et al. Coronary artery disease in patients with out-of-hospital refractory ventricular fibrillation cardiac arrest. J Am Coll Cardiol. 2017;70: 1109–17.

4. Dennis M, Zmudzki F, Burns B, Scott S, Gattas D, Reynolds C, et al. Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. Resuscitation. 2019;139:49– 56.

5. Kawashima T, Uehara H, Miyagi N, Shimajiri M, Nakamura K, Chinen T, et al. Impact of first documented rhythm on cost-effectiveness of extracorporeal cardiopulmonary resuscitation. Resuscitation. 2019;140:74–80.

6. Shin J, Lim YS, Kim K, Lee HJ, Lee SJ, Jung E, et al. Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study. Crit Care. 2017;21:322.

7. Takaki S, Kamiya Y, Tahara Y, Tou M, Shimoyama A, Iwashita M. Blood pH is a useful indicator for initiation of therapeutic hypothermia in the early phase of resuscitation after comatose cardiac arrest: a retrospective study. J Emerg Med. 2013;45:57–64.

8. Momiyama Y, Yamada W, Miyata K, Miura K, Fukuda T, Fuse J, et al. Prognostic values of blood pH and lactate levels in patients resuscitated from out-of-hospital cardiac arrest. Acute Med Surg. 2017;4:25–30.

9. Hope Kilgannon J, Hunter BR, Puskarich MA, Shea L, Fuller BM, Jones C, et al. Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study. Resuscitation. 2019;135:212–20.

10. Truhlar A, Deakin CD, Soar J, Khalifa GE, Alfonzo A, Bierens JJ, et al. European Resuscitation Council Guidelines for Resuscitation 2015: section 4. Cardiac arrest in special circumstances. Resuscitation. 2015;95:148–201.

11. Cowley NJ, Owen A, Bion JF. Interpreting arterial blood gas results. BMJ. 2013;346:f16.

12. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC. Vandenbroucke JP; STROBE Initiative. The STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7.

13. Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H. Hiraide A; Implementation working group for the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Nationwide public-access defibrillation in Japan. N Engl J Med. 2010;362:994–1004.

14. Kitamura T, Kiyohara K, Sakai T, Matsuyama T, Hatakeyama T, Shimamoto T, et al. Public-access defibrillation and out-of-hospital cardiac arrest in Japan. N Engl J Med. 2016;375:1649–59.

15. Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa). Circulation. 2004;110:3385–97.

16. Yamada T, Kitamura T, Hayakawa K, Yoshiya K, Irisawa T, Abe Y, et al. Rationale, design, and profile of Comprehensive Registry of In-Hospital Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan. J Intensive Care. 2016;4:10.

17. Statistics Bureau (Japan). https://www.stat.go.jp/english/. Accessed 17 Nov 2019.

18. Fire and Disaster Management Agency of the Ministry of Internal Affairs and Communications (Japan). http://www.fdma.go.jp/neuter/topics/fieldList9_3. html. Accessed 7 Jun 2018.

19. Brooks SC, Anderson ML, Bruder E, Daya MR, Gaffney A, Otto CW, et al. Part 6: Alternative techniques and ancillary devices for cardiopulmonary resuscitation: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S436–43.

20. Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007;24:569–71.

21. Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med J. 2001;18:340–2.

22. Hughes RA, Heron J, Sterne JAC, Tilling K. Accounting for missing data in statistical analyses: multiple imputation is not always the answer. Int J Epidemiol. 2019;48:1294–304.

23. Reddy AJ, Lam SW, Bauer SR, Guzman JA. Lactic acidosis: Clinical implications and management strategies. Cleve Clin J Med. 2015;82: 615–24.

24. Magliocca A, Olivari D, De Giorgio D, Zani D, Manfredi M, Boccardo A, et al. LUCAS versus manual chest compression during ambulance transport: a hemodynamic study in a porcine model of cardiac arrest. J Am Heart Assoc. 2019;8:e011189.

25. Takasu A, Sakamoto T, Okada Y. Arterial base excess after CPR: the relationship to CPR duration and the characteristics related to outcome. Resuscitation. 2007;23:394–9.

26. Orban JC, Novain M, Cattet F, Plattier R, Nefzaoui M, Hyvernat H, et al. Association of serum lactate with outcome after out-of-hospital cardiac arrest treated with therapeutic hypothermia. PLoS One. 2017;12:e0173239.

27. Jamme M, Ben Hadj Salem O, Guillemet L, Dupland P, Bougouin W, Charpentier J, et al. Severe metabolic acidosis after out-of-hospital cardiac arrest: risk factors and association with outcome. Ann Intensive Care. 2018;8: 62.

28. Carden DL, Martin GB, Nowak RM, Foreback CC, Tomlanovich MC. Lactic acidosis as a predictor of downtime during cardiopulmonary arrest in dogs. Am J Emerg Med. 1985;3:120–4.

29. Sandroni C, De Santis P, D'Arrigo S. Capnography during cardiac arrest. Resuscitation. 2018;132:73–7.

30. McKenzie N, Williams TA, Tohira H, Ho KM, Finn J. A systematic review and meta-analysis of the association between arterial carbon dioxide tension and outcomes after cardiac arrest. Resuscitation. 2017;111:116–26.

31. Tiruvoipati R, Pilcher D, Botha J, Buscher H, Simister R, Bailey M. Association of hypercapnia and hypercapnic acidosis with clinical outcomes in mechanically ventilated patients with cerebral injury. JAMA Neurol. 2018;75: 818–26.

32. Ilicki J, Djarv T. Survival in extremely acidotic cardiac arrest patients depends on etiology of acidosis. Resuscitation. 2017;113:e25.

33. Wang J, Ma Q, Zhang H, Liu S, Zheng Y. Predictors of survival and neurologic outcome for adults with extracorporeal cardiopulmonary resuscitation: a systemic review and meta-analysis. Medicine (Baltimore). 2018;97:e13257.

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