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Title: Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan
Authors: Okada, Yohei
Kiguchi, Takeyuki  kyouindb  KAKEN_id
Irisawa, Taro
Yoshiya, Kazuhisa
Yamada, Tomoki
Hayakawa, Koichi
Noguchi, Kazuo
Nishimura, Tetsuro
Ishibe, Takuya
Yagi, Yoshiki
Kishimoto, Masafumi
Shintani, Hiroshi
Hayashi, Yasuyuki
Sogabe, Taku
Morooka, Takaya
Sakamoto, Haruko
Suzuki, Keitaro
Nakamura, Fumiko
Nishioka, Norihiro
Matsuyama, Tasuku
Sado, Junya
Matsui, Satoshi
Shimazu, Takeshi
Koike, Kaoru
Kawamura, Takashi  KAKEN_id
Kitamura, Tetsuhisa
Iwami, Taku  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-4150-7065 (unconfirmed)
the CRITICAL Study Group Investigators
Author's alias: 岡田, 遥平
木口, 雄之
入澤, 太郎
吉矢, 和久
山田, 知輝
早川, 航一
野口, 和男
西村, 哲郎
石部, 琢也
八木, 良樹
岸本, 正文
林, 靖之
師岡, 誉也
坂本, 晴子
中村, 文子
西岡, 典宏
松山, 匡
佐道, 准也
松井, 鋭
嶋津, 岳士
小池, 薫
川村, 孝
北村, 哲久
石見, 拓
Keywords: Extracorporeal membrane oxygenation (ECMO)
Percutaneous cardiopulmonary support (PCPS)
Ventricular fibrillation
Extracorporeal life support
Blood gas assessment
Issue Date: 11-May-2020
Publisher: Springer Science and Business Media LLC
Journal title: Journal of Intensive Care
Volume: 8
Thesis number: 34
Abstract: Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875–7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10–0.63) and 0.24 (95% CI 0.09–0.61), respectively. Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.
Rights: © The Author(s). 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
URI: http://hdl.handle.net/2433/253541
DOI(Published Version): 10.1186/s40560-020-00451-6
PubMed ID: 32426140
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