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Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation.
Jabre, Patricia; Bougouin, Wulfran; Dumas, Florence; Carli, Pierre; Antoine, Corinne; Jacob, Laurent; Dahan, Benjamin; Beganton, Frankie; Empana, Jean-Philippe; Marijon, Eloi; Karam, Nicole; Loupy, Alexandre; Lefaucheur, Carmen; Jost, Daniel; Cariou, Alain; Adnet, Frédéric; Rea, Thomas D; Jouven, Xavier.
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  • Jabre P; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Bougouin W; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Dumas F; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Carli P; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Antoine C; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Jacob L; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Dahan B; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Beganton F; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Empana JP; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Marijon E; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Karam N; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Loupy A; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Lefaucheur C; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Jost D; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Cariou A; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Adnet F; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Rea TD; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
  • Jouven X; From Paris Cardiovascular Research Center, Hôpital Necker-Enfants Malades, Hôpital Cochin, Université Paris Descartes-Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris VII, Hôpital Européen Georges Pompidou, and Paris Fire Brigade, Paris, France; Hôpital Avicenne, Université
Ann Intern Med ; 165(11): 770-778, 2016 Dec 06.
Article en En | MEDLINE | ID: mdl-27618681
ABSTRACT

BACKGROUND:

In patients with out-of-hospital cardiac arrest (OHCA), care requirements can conflict with the need to promptly focus efforts on organ donation in patients who are pronounced dead.

OBJECTIVE:

To evaluate objective criteria for identifying patients with OHCA with no chance of survival during the first minutes of cardiopulmonary resuscitation to enable prompt orientation toward organ donation.

DESIGN:

Retrospective assessment using OHCA data from 2 registries and 1 trial.

SETTING:

France (Paris Sudden Death Expertise Center [SDEC] prospective cohort [2011 to 2014] and PRESENCE multicenter cluster randomized trial [ClinicalTrials.gov NCT01009606] [2009 to 2011]) and the United States (King County, Washington, prospective cohort [2006 to 2011]). PATIENTS 1771 patients from the Paris SDEC 1-year cohort (2011 to 2012) and 5192 from the validation cohorts. MEASUREMENTS Evaluation of 3 objective criteria (OHCA not witnessed by emergency medical services personnel, nonshockable initial cardiac rhythm, and no return of spontaneous circulation before receipt of a third 1-mg dose of epinephrine), survival rate at hospital discharge among patients meeting these criteria, performance of the criteria, and number of patients eligible for organ donation.

RESULTS:

In the Paris SDEC 1-year cohort, the survival rate among the 772 patients with OHCA who met the objective criteria was 0% (95% CI, 0.0% to 0.5%), with a specificity of 100% (CI, 97% to 100%) and a positive predictive value of 100% (CI, 99% to 100%). These results were verified in the validation cohorts. Ninety-five (12%) patients in the Paris SDEC 1-year cohort may have been eligible for organ donation.

LIMITATION:

Several patients had unknown outcomes.

CONCLUSION:

Three objective criteria enable the early identification of patients with OHCA with essentially no chance of survival and may help in decision making about the organ donation process. PRIMARY FUNDING SOURCE French Ministry of Health.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Paro Cardíaco Extrahospitalario Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Screening_studies Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte / Europa Idioma: En Revista: Ann Intern Med Año: 2016 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Paro Cardíaco Extrahospitalario Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Screening_studies Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte / Europa Idioma: En Revista: Ann Intern Med Año: 2016 Tipo del documento: Article