Association between defibrillation-to-adrenaline interval and short-term outcomes in patients with out-of-hospital cardiac arrest and an initial shockable rhythm

被引：1

作者：

Kawakami, Shoji ^{[1
,2
]}

Tahara, Yoshio ^{[2
]}

Noguchi, Teruo ^{[2
]}

Yasuda, Satoshi ^{[2
,3
]}

Koga, Hidenobu ^{[4
]}

Nishi, Jun-ichiro ^{[1
]}

Yonemoto, Naohiro ^{[5
]}

Nonogi, Hiroshi ^{[6
]}

Ikeda, Takanori ^{[7
]}

机构：

[1] Aso Iizuka Hosp, Dept Cardiol, Fukuoka, Japan

[2] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Japan

[3] Tohoku Univ, Dept Cardiovasc Med, Grad Sch Med, 1-1 Seiryo Machi,Aoba Ku, Sendai, Miyagi 9808574, Japan

[4] Aso Iizuka Hosp, Clin Res Support Off, Fukuoka, Japan

[5] Juntendo Univ, Sch Med, Dept Publ Hlth, Tokyo, Japan

[6] Osaka Aoyama Univ, Fac Hlth Sci, Mino, Japan

[7] Toho Univ, Fac Med, Dept Cardiovasc Med, Tokyo, Japan

来源：

RESUSCITATION PLUS | 2024年 / 18卷

关键词：

Adrenaline; Defibrillation; Shockable rhythm; Cardiac arrest; EUROPEAN RESUSCITATION COUNCIL; AMERICAN-HEART-ASSOCIATION; CARDIOPULMONARY-RESUSCITATION; EPINEPHRINE; GUIDELINES; DURATION;

D O I：

10.1016/j.resplu.2024.100651

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Aim: The optimal timing of adrenaline administration after defibrillation in patients with out -of -hospital cardiac arrest (OHCA) and an initial shockable rhythm is unknown. We investigated the association between the defibrillation -to -adrenaline interval and clinical outcomes. Methods: Between 2011 and 2020, we enrolled 1,259,960 patients with OHCA into a nationwide prospective population -based registry in Japan. After applying exclusion criteria, 20,905 patients with an initial shockable rhythm documented at emergency medical services (EMS) arrival who received adrenaline after defibrillation were eligible for this study. Multivariable logistic regression analysis was used to predict favourable shortterm outcomes: prehospital return of spontaneous circulation (ROSC), 30 -day survival, or a favourable neurological outcome (Cerebral Performance Category 1 or 2) at 30 days. Patients were categorised into 2 -minute defibrillation -to -adrenaline intervals up to 18 min, or more than 18 min. Results: At 30 days, 1,618 patients (8%) had a favourable neurological outcome. The defibrillation -to -adrenaline interval in these patients was significantly shorter than in patients with an unfavourable neurological outcome [8 (5-12) vs 11 (7-16) minutes; P < 0.001]. The proportion of patients with prehospital ROSC, 30 -day survival, or a favourable neurological outcome at 30 days decreased as the defibrillation -to -adrenaline interval increased (P < 0.001 for trend). Multivariable analysis revealed that a defibrillation -to -adrenaline interval of > 6 min was an independent predictor of worse prehospital ROSC, 30 -day survival, or neurological outcome at 30 days when compared with an interval of 4-6 min. Conclusion: A longer defibrillation -to -adrenaline interval was significantly associated with worse short-term outcomes in patients with OHCA and an initial shockable rhythm.

引用

页数：8

共 50 条

[1] Association Between Defibrillation to Epinephrine Interval and Short-Term Outcomes in Out-ofHospital Cardiac Arrest Patients With Shockable Rhythm
Kawakami, Shoji
Tahara, Yoshio
Noguchi, Teruo
Yasuda, Satoshi
Nishi, Jun-Ichiro
Nishimura, Kunihiro
Yonemoto, Naohiro W.
Nonogi, Hiroshi
Nagao, Ken
Ikeda, Takanori
CIRCULATION, 2023, 148
[2] Association between shockable rhythm conversion and outcomes in patients with out-of-hospital cardiac arrest and initial non-shockable rhythm, according to the cause of cardiac arrest
Han, Kap Su
Lee, Sung Woo
Lee, Eui Jung
Kwak, Moon Hwan
Kim, Su Jin
RESUSCITATION, 2019, 142 : 144 - 152
[3] The association between public access defibrillation and outcome in witnessed out-of-hospital cardiac arrest with shockable rhythm
Kiyohara, Kosuke
Nishiyama, Chika
Kitamura, Tetsuhisa
Matsuyama, Tasuku
Sado, Junya
Shimamoto, Tomonari
Kobayashi, Daisuke
Kiguchi, Takeyuki
Okabayashi, Satoe
Kawamura, Takashi
Iwami, Taku
RESUSCITATION, 2019, 140 : 93 - 97
[4] Clinical features and outcomes of patients with refractory out-of-hospital cardiac arrest and an initial shockable rhythm
Zheng, W.
Ho, F.
Zheng, M.
Noaman, S.
Haji, K.
Batchelor, R.
Hanson, L.
Bloom, J.
Shaw, J.
Yang, Y.
Stub, D.
Cox, N.
Kaye, D.
Chan, W.
EUROPEAN HEART JOURNAL, 2023, 44
[5] Epinephrine Before Defibrillation In Adults With Shockable Rhythm Out-of-hospital Cardiac Arrest
Luo, Shengyuan
Gu, Liwen
Zhang, Wanwan
Zhang, Yongshu
Li, Wankun
Qiu, Feipeng
Xiong, Yan
Idris, Ahamed H.
CIRCULATION, 2022, 146
[6] Sex differences in the association of comorbidity with shockable initial rhythm in out-of-hospital cardiac arrest
van Dongen, Laura H.
Oving, Iris
Dijkema, Pauline W.
Beesems, Stefanie G.
Blom, Marieke T.
Tan, Hanno L.
RESUSCITATION, 2021, 167 : 173 - 179
[7] Association Between Time to First Administration of Epinephrine After Defibrillation and Outcome in Out-Of-Hospital Cardiac Arrest Patients With Shockable Rhythm
Kawakami, Shoji
Tahara, Yoshio
Noguchi, Teruo
Yasuda, Satoshi
Yonemoto, Naohiro W.
Nonogi, Hiroshi
Nagao, Ken
Ikeda, Takanori
Sato, Naoki
Tsutsui, Hiroyuki
CIRCULATION, 2019, 140
[8] Clinical Features and Outcomes Among Patients With Refractory Out-of-Hospital Cardiac Arrest and an Initial Shockable Rhythm
Zheng, Wayne C.
Zheng, Maye C.
Ho, Felicia C. S.
Noaman, Samer
Haji, Kawa
Batchelor, Riley J.
Hanson, Laura B.
Bloom, Jason E.
Shaw, James A.
Yang, Yang
Stub, Dion
Cox, Nicholas
Kaye, David M.
Chan, William
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2023, 16 (10) : 637 - 647
[9] Delays in Care and Outcomes in Out-of-Hospital Cardiac Arrest With Shockable Rhythm
Wheelock, Kevin M.
Miller, Elliott
Khera, Rohan
CIRCULATION, 2022, 146
[10] Prognostic Value of the Conversion to a Shockable Rhythm in Out-of-Hospital Cardiac Arrest Patients with Initial Non-Shockable Rhythm
Han, Kap Su
Lee, Sung Woo
Lee, Eui Jung
Kim, Su Jin
JOURNAL OF CLINICAL MEDICINE, 2019, 8 (05)

← 1 2 3 4 5 →