Universität zu Köln

Adler, Christoph, Paul, Christian, Michels, Guido, Pfister, Roman, Sabashnikov, Anton, Hinkelbein, Jochen, Braumann, Simon, Djordjevic, Llija, Blomeyer, Ralf, Krings, Andrea, Boettiger, Bernd W., Baldus, Stephan and Stangl, Robert (2019). One year experience with fast track algorithm in patients with refractory out-of-hospital cardiac arrest. Resuscitation, 144. S. 157 - 166. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-1570

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Abstract

Background: Overall prognosis in patients with out-of-hospital cardiac arrest (OHCA) remains poor, especially when return of spontaneous circulation (ROSC) cannot be achieved at the scene. It is unclear if rapid transport to the hospital with ongoing cardiopulmonary resuscitation (CPR) improves outcome in patients with refractory OHCA (rOHCA). The aim of this study was to evaluate the effect of a novel fast track algorithm (FTA) in patients with rOHCA. Methods: This prospective single-center study analysed outcome in rOHCA patients treated with FTA. Historical patients before FTA-implementation served as controls. rOHCA was defined as: persistent shockable rhythm after three shocks and 300 mg of amiodarone or persistent non-shockable rhythm and continuous CPR for 10 min without ROSC after exclusion of treatable arrest causes. Results: 110 consecutive patients with rOHCA (mean age 56 +/- 14 years) were included. 40 patients (36%) were treated with FTA, 70 patients (64%) served as historical controls. Pre-hospital time was significantly shorter after FTA implementation (69 +/- 18 vs. 79 +/- 24 min, p = 0.02). Favourable neurological outcome (defined as cerebral performance categories Score 1 or 2) was significantly more frequent in FTA patients (27.5% vs. 11.4%, p = 0.038). FTA-implementation showed a trend towards improved mortality (70.0% vs. 82.9%, p = 0.151). Extracorporeal Life Support was similar between the two groups. Conclusion: Our study suggests that a rapid transport algorithm with ongoing CPR is feasible, improves neurological outcome and may improve survival in carefully selected patients with rOHCA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Paul, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinkelbein, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Braumann, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Llija UNSPECIFIED UNSPECIFIED UNSPECIFIED Blomeyer, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Krings, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Boettiger, Bernd W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Stangl, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129584
DOI:	10.1016/j.resuscitation.2019.07.035
Journal or Publication Title:	Resuscitation
Volume:	144
Page Range:	S. 157 - 166
Date:	2019
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1873-1570
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTRACORPOREAL CARDIOPULMONARY-RESUSCITATION; MILD THERAPEUTIC HYPOTHERMIA; AMERICAN-HEART-ASSOCIATION; RECOMMENDED GUIDELINES; COUNCIL GUIDELINES; STROKE-FOUNDATION; TASK-FORCE; LIFE; PROFESSIONALS; STATEMENT Multiple languages Critical Care Medicine; Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12958