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

Annals of Intensive Care

Table 2 Logistic regression analysis for favourable neurological outcome

Variables	Unadjusted odds ratio (95% CI) n = 166	P value	Adjusted odds ratio^A (95% CI) n = 166^a	P value	Adjusted odds ratio^B (95% CI) n = 158^a	P value
Age (y)	0.96 (0.93–0.99)	0.003
Male sex	0.82 (0.35–1.95)	0.655
Cardiac arrest witnessed	1.07 (0.48–2.38)	0.876
Bystander CPR attempt	2.70 (1.20–6.06)	0.016
Initial recorded cardiac arrest rhythm			0.62 (0.42–0.93)	0.02	0.63 (0.42–0.95)	0.028
VF or pulseless VT	0.78 (0.28–2.19)	0.641
Pulseless electrical activity	0.96 (0.28–3.36)	0.954
Asystole	1.000 (ref.)	0.850
Gasping during transportation by EMS	8.37 (3.64–19.27)	<.001	9.52 (5.31–17.08)	< .001	9.94 (5.49–18.00)	< .001
Aetiology of cardiac arrest	0.59 (0.25–1.38)	0.225
Epinephrine dose before hospital admission, mg	0.70 (0.54–0.92)	0.009
Cardiac rhythm at admission
ROSC	8.25 (1.58–43.13)	0.012
VF or pulseless VT	1.77 (0.54–5.79)	0.344
Pulseless electrical activity	0.72 (0.18–2.80)	0.633
Asystole	1.000 (ref.)	0.013
Low-flow duration, min	0.98 (0.95–1.00)	0.075	0.99 (0.97–1.01)	0.34	0.99 (0.97–1.01)	0.510
No-flow duration, min, n = 115^b	0.88 (0.80–0.98)	0.018
pH at admission, n = 162^c	9.88 (0.77–127.38)	0.079
Serum lactate value at admission, n = 158^c	1.01 (0.93–1.10)	0.783			1.03 (0.97–1.09)	0.399
Epinephrine administration after admission, mg	0.76 (0.57–1.02)	0.070
Intra-aortic balloon pumping	1.36 (0.59–3.17)	0.471
Percutaneous coronary intervention	0.94 (0.44–1.98)	0.865
Therapeutic temperature management	1.62 (0.70–3.74)	0.261

CPR cardiopulmonary resuscitation, VF ventricular fibrillation, VT ventricular tachycardia, EMS emergency medical service, ROSC return of spontaneous circulation
^aFor the multivariate logistic analysis, the initial cardiac rhythm, and low-flow time were selected as populated variables with reference to previous reports [13, 21], and gasping during transportation, which is the subject of this study, were also added (showing adjusted odds ratio^A). In the adjusted odds ratio^B, the serum lactate value for which the sample number missing was also entered in the multivariate logistic analysis
^bNo-flow time could be basically calculated in patients with witnessed cardiac arrest, while 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 time was less than 166
^cThe number was less than 166 due to insufficient data