Fluid balance during acute phase extracorporeal cardiopulmonary resuscitation and outcomes in OHCA patients: a retrospective multicenter cohort study
- 18.04.2024
- Original Paper
Erschienen in:
- Verfasst von
- Takuya Taira
- Akihiko Inoue
- Hiroshi Okamoto
- Kunihiko Maekawa
- Toru Hifumi
- Tetsuya Sakamoto
- Yasuhiro Kuroda
- Masafumi Suga
- Takeshi Nishimura
- Shinichi Ijuin
- Satoshi Ishihara
- The SAVE-J II study group
- Erschienen in
- Clinical Research in Cardiology | Ausgabe 10/2025
Abstract
Objective
The association between fluid balance and outcomes in patients who underwent out-of-hospital cardiac arrest (OHCA) and received extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to examine the above relationship during the first 24 h following intensive care unit (ICU) admission.
Methods
We performed a secondary analysis of the SAVE-J II study, a retrospective multicenter study involving OHCA patients aged ≥ 18 years treated with ECPR between 2013 and 2018 and who received fluid therapy following ICU admission. Fluid balance was calculated based on intravenous fluid administration, blood transfusion, and urine output. The primary outcome was in-hospital mortality. The secondary outcomes included unfavorable outcome (cerebral performance category scores of 3–5 at discharge), acute kidney injury (AKI), and need for renal replacement therapy (RRT).
Results
Overall, 959 patients met our inclusion criteria. In-hospital mortality was 63.6%, and the proportion of unfavorable outcome at discharge was 82.0%. The median fluid balance in the first 24 h following ICU admission was 3673 mL. Multivariable analysis revealed that fluid balance was significantly associated with in-hospital mortality (odds ratio (OR), 1.04; 95% confidence interval (CI), 1.02–1.06; p < 0.001), unfavorable outcome (OR, 1.03; 95% CI, 1.01–1.06; p = 0.005), AKI (OR, 1.04; 95% CI, 1.02–1.05; p < 0.001), and RRT (OR, 1.05; 95% CI, 1.03–1.07; p < 0.001).
Conclusions
Excessive positive fluid balance in the first day following ICU admission was associated with in-hospital mortality, unfavorable outcome, AKI, and RRT in ECPR patients. Further investigation is warranted.
Graphical abstract
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- Titel
- Fluid balance during acute phase extracorporeal cardiopulmonary resuscitation and outcomes in OHCA patients: a retrospective multicenter cohort study
- Verfasst von
-
Takuya Taira
Akihiko Inoue
Hiroshi Okamoto
Kunihiko Maekawa
Toru Hifumi
Tetsuya Sakamoto
Yasuhiro Kuroda
Masafumi Suga
Takeshi Nishimura
Shinichi Ijuin
Satoshi Ishihara
The SAVE-J II study group
- Publikationsdatum
- 18.04.2024
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Clinical Research in Cardiology / Ausgabe 10/2025
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692 - DOI
- https://doi.org/10.1007/s00392-024-02444-z
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