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Optimal duration and timing of basic-life-support-only intervention for patients with out-of-hospital cardiac arrest.
Takei, Yutaka; Toyama, Gen; Takahashi, Tsukasa; Omatsu, Kentaro.
Afiliação
  • Takei Y; Graduate School of Health and Welfare, Niigata University of Health and Welfare, 1398 Shimami-Cho, Kita-Ku, Niigata, 950-3198, Japan. yutaka-takei@nuhw.ac.jp.
  • Toyama G; Graduate School of Health and Welfare, Niigata University of Health and Welfare, 1398 Shimami-Cho, Kita-Ku, Niigata, 950-3198, Japan.
  • Takahashi T; Graduate School of Health and Welfare, Niigata University of Health and Welfare, 1398 Shimami-Cho, Kita-Ku, Niigata, 950-3198, Japan.
  • Omatsu K; Graduate School of Health and Welfare, Niigata University of Health and Welfare, 1398 Shimami-Cho, Kita-Ku, Niigata, 950-3198, Japan.
Sci Rep ; 14(1): 6071, 2024 03 13.
Article em En | MEDLINE | ID: mdl-38480805
ABSTRACT
To elucidate the relationship between the interval from cardiopulmonary resuscitation initiation to return of spontaneous circulation (ROSC) and neurologically favourable 1-month survival in order to determine the appropriate duration of basic life support (BLS) without advanced interventions. This population-based cohort study included patients aged ≥ 18 years with 9132 out-of-hospital cardiac arrest of presumed cardiac origin who were bystander-witnessed and had achieved ROSC between 2018 and 2020. Patients were classified into two groups based on the resuscitation methods as the "BLS-only" and the "BLS with administered epinephrine (BLS-AE)" groups. Receiver operating characteristic (ROC) curve analysis indicated that administering BLS for 9 min yielded the best neurologically outcome for patients with a shockable rhythm [sensitivity, 0.42; specificity, 0.27; area under the ROC curve (AUC), 0.60] in the BLS-only group. Contrastingly, for patients with a non-shockable rhythm, performing BLS for 6 min yielded the best neurologically outcome (sensitivity, 0.65; specificity, 0.43; AUC, 0.63). After propensity score matching, multivariate analysis revealed that BLS-only resuscitation [6.44 (5.34-7.77)] was associated with neurologically favourable 1-month survival. This retrospective study revealed that BLS-only intervention had a significant impact in the initial minutes following CPR initiation. Nevertheless, its effectiveness markedly declined thereafter. The optimal duration for effective BLS-only intervention varied depending on the patient's initial rhythm. Consequently, advanced interventions should be administered within the first few minutes to counteract the diminishing effectiveness of BLS-only intervention.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reanimação Cardiopulmonar / Serviços Médicos de Emergência / Parada Cardíaca Extra-Hospitalar Limite: Humans Idioma: En Revista: Sci Rep Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reanimação Cardiopulmonar / Serviços Médicos de Emergência / Parada Cardíaca Extra-Hospitalar Limite: Humans Idioma: En Revista: Sci Rep Ano de publicação: 2024 Tipo de documento: Article