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Erschienen in:

03.04.2020 | Original Paper

How long is long enough? Good neurologic outcome in out-of-hospital cardiac arrest survivors despite prolonged resuscitation: a retrospective cohort study

verfasst von: Simon Braumann, Felix Sebastian Nettersheim, Christopher Hohmann, Tobias Tichelbäcker, Martin Hellmich, Anton Sabashnikov, Ilija Djordjevic, Joana Adler, Richard Julius Nies, Dennis Mehrkens, Samuel Lee, Robert Stangl, Hannes Reuter, Stephan Baldus, Christoph Adler

Erschienen in: Clinical Research in Cardiology | Ausgabe 11/2020

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Abstract

Background

Despite all efforts, mortality of out of hospital cardiac arrest (OHCA) remains high. Patients with OHCA due to a primary shockable rhythm typically have a better prognosis. However, outcome worsens if return of spontaneous circulation (ROSC) cannot be achieved quickly. There is insufficient evidence for maximum duration of resuscitation in these patients and it is unclear, which patients profit from transport under ongoing CPR.

Objective

Investigate predictors for favourable neurologic outcome in OHCA patients with presumed cardiac cause due to refractory shockable rhythm (rSR).

Methods

Retrospective analysis of OHCA patients that presented to a tertiary hospital due to a rSR.

Results

One hundred seventy-five OHCA patients with presumed cardiac cause due to rSR were included. Overall hospital mortality was 50% and 83% of initial survivors were discharged with a good neurologic outcome [cerebral performance category (CPC) 1–2]. In patients with a time from cardiac arrest to ROSC of > 45 min, 18% survived to CPC 1–2. Independent predictors for good neurologic outcome were age, lower no-flow time and lower serum lactate levels at hospital arrival.

Conclusion

In an urban setting, a significant proportion of OHCA patients with rSR can survive to a good neurologic outcome, despite very long time to ROSC.

Graphic abstract

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Titel: How long is long enough? Good neurologic outcome in out-of-hospital cardiac arrest survivors despite prolonged resuscitation: a retrospective cohort study
verfasst von: Simon Braumann
Felix Sebastian Nettersheim
Christopher Hohmann
Tobias Tichelbäcker
Martin Hellmich
Anton Sabashnikov
Ilija Djordjevic
Joana Adler
Richard Julius Nies
Dennis Mehrkens
Samuel Lee
Robert Stangl
Hannes Reuter
Stephan Baldus
Christoph Adler
Publikationsdatum: 03.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 11/2020
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01640-x

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How long is long enough? Good neurologic outcome in out-of-hospital cardiac arrest survivors despite prolonged resuscitation: a retrospective cohort study