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Emergencias. 2018 Jun;30(3):156-162.

Ambulance cardiopulmonary resuscitation: outcomes and associated factors in out-of-hospital cardiac arrest.

[Article in English, Spanish; Abstract available in Spanish from the publisher]

Author information

1
Empresa Pública de Emergencias Sanitarias de Andalucía, Almería, España.
2
Unidad de Investigación, Hospital Virgen del Rocío, Sevilla, España.
3
Servicio de Urgencias, Hospital el Toyo, Almería, España.
4
Facultad de Medicina, Universidad de Granada, España.
5
Unidad de Cuidados Intensivos, Hospital de Linares, Jaén, España.

Abstract

in English, Spanish

OBJECTIVES:

To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport.

MATERIAL AND METHODS:

Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome.

RESULTS:

Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91-10.76); P<.001)], witnessed OHCA (OR, 1.62; 95% CI, 1.16-2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38-4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07-2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17-2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58-4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24-2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome.

CONCLUSION:

Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.

KEYWORDS:

Ambulance cardiopulmonary resuscitation; Emergency health services; Futile cardiopulmonary resuscitation; Parada cardiaca extrahospitalaria; Reanimación cardiopulmonar en curso; Reanimación fútil; Servicio de emergencias

PMID:
29687669
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