Gasping during refractory out-of-hospital cardiac arrest is a prognostic marker for favourable neurological outcome following extracorporeal cardiopulmonary resuscitation: a retrospective study

Bunya, Naofumi; Ohnishi, Hirofumi; Wada, Kenshiro; Kakizaki, Ryuichiro; Kasai, Takehiko; Nagano, Nobutaka; Kokubu, Nobuaki; Miyata, Kei; Uemura, Shuji; Harada, Keisuke; Narimatsu, Eichi

doi:10.1186/s13613-020-00730-3

Annals of Intensive Care

Table 1 Comparison of baseline characteristics based on neurological outcome

From: Gasping during refractory out-of-hospital cardiac arrest is a prognostic marker for favourable neurological outcome following extracorporeal cardiopulmonary resuscitation: a retrospective study

variables	Favourable neurological outcome, n = 35	Unfavourable neurological outcome, n = 131	P value
Age (y)	53.0 (43.0, 64.5)	63.0 (50.0, 70.0)	0.004
Male sex, n (%)	26 (74.3)	102 (77.9)	0.655
Cardiac arrest witnessed, n (%)	24 (68.6)	88 (67.2)	0.876
Bystander CPR attempt, n (%)	25(71.4)	63(48.1)	0.014
Initial recorded cardiac arrest rhythm, n (%)			0.709
VF or pulseless VT	22 (62.9)	89 (67.9)
Pulseless electrical activity	7 (20.0)	23 (17.6)
Asystole	6 (17.1)	19 (14.5)
Gasping during transportation by EMS, n (%)	20 (57.1)	18 (13.7)	< 0.001
Aetiology of cardiac arrest, n (%)			0.222
Cardiac, n (%)	25 (71.4)	106 (80.9)
No cardiac, n (%)	10 (28.6)	25 (19.1)
Pulmonary embolism	1	2
Subarachnoid haemorrhage	0	3
Accidental hypothermia	8	6
Acute aortic dissection	0	3
Respiratory disease
Pneumonia	0	1
Chronic obstructive pulmonary disease	0	1
Asthma	0	1
Other	1	8
Epinephrine dose before hospital admission, mg	0.0 (0.0, 2.0)	2.0 (0.0, 3.0)	0.002
Cardiac rhythm at admission			0.009
ROSC^a	6 (17.1)	4 (3.1)
VF or pulseless VT	19 (54.3)	59 (45.0)
Pulseless electrical activity	6 (17.1)	46 (35.1)
Asystole	4 (11.4)	22 (16.8)
Low-flow duration, min	42.00 (30.00, 55.00)	46.00 (36.00, 54.00)	0.299
No-flow duration, min, median, n = 115^b	0.00 (0.00, 1.50), n = 26^b	2.00 (0.00, 10.00), n = 89^b	0.006
pH at admission, n = 162^c	6.94 (6.88, 7.06), n = 35	6.90 (6.81, 7.02), n = 127	0.098
Serum lactate at admission, n = 158^c	13.7 (8.7, 16.0), n = 35	12.7 (11.0, 15.2), n = 123	0.948
Epinephrine administration after admission, mg	1.0 (0.0, 2.0)	1.0 (0.0, 3.0)	0.036
Intra-aortic balloon pumping, n (%)	26 (74.3)	89 (67.9)	0.470
Percutaneous coronary intervention, n (%)	16 (45.7)	62 (47.3)	0.865
Therapeutic temperature management, n (%)	26 (74.3)	84 (64.1)	0.259

Numbers shown in parentheses are percentages, and continuous variables were presented as median with interquartile ranges
CPR cardiopulmonary resuscitation, VF ventricular fibrillation, VT ventricular tachycardia, EMS emergency medical service, ROSC return of spontaneous circulation
^aThese cases exhibited repeated ROSC and cardiac arrest. Therefore, these patients underwent extracorporeal cardiopulmonary resuscitation
^bNo-flow time could be basically calculated in patients with witnessed cardiac arrest while that for some un-witnessed cardiac arrest patients, no-flow time could be estimated by relatives and/or bystanders. Accordingly, the number of patients with no-flow was less than 166
^cThe numbers were less than 166 due to insufficient data

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