Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Suverein Martje M, Delnoij Thijs S R, Lorusso Roberto, Brandon Bravo Bruinsma George J, Otterspoor Luuk, Elzo Kraemer Carlos V, Vlaar Alexander P J, van der Heijden Joris J, Scholten Erik, den Uil Corstiaan, Jansen Tim, van den Bogaard Bas, Kuijpers Marijn, Lam Ka Yan, Montero Cabezas José M, Driessen Antoine H G, Rittersma Saskia Z H, Heijnen Bram G, Dos Reis Miranda Dinis, Bleeker Gabe, de Metz Jesse, Hermanides Renicus S, Lopez Matta Jorge, Eberl Susanne, Donker Dirk W, van Thiel Robert J, Akin Sakir, van Meer Oene, Henriques José, Bokhoven Karen C, Mandigers Loes, Bunge Jeroen J H, Bol Martine E, Winkens Bjorn, Essers Brigitte, Weerwind Patrick W, Maessen Jos G, van de Poll Marcel C G
Аннотация
METHODS: In this multicenter, randomized, controlled trial conducted in the Netherlands, we assigned patients with an out-of-hospital cardiac arrest to receive extracorporeal CPR or conventional CPR (standard advanced cardiac life support). Eligible patients were between 18 and 70 years of age, had received bystander CPR, had an initial ventricular arrhythmia, and did not have a return of spontaneous circulation within 15 minutes after CPR had been initiated. The primary outcome was survival with a favorable neurologic outcome, defined as a Cerebral Performance Category score of 1 or 2 (range, 1 to 5, with higher scores indicating more severe disability) at 30 days. Analyses were performed on an intention-to-treat basis.
RESULTS: Of the 160 patients who underwent randomization, 70 were assigned to receive extracorporeal CPR and 64 to receive conventional CPR; 26 patients who did not meet the inclusion criteria at hospital admission were excluded. At 30 days, 14 patients (20%) in the extracorporeal-CPR group were alive with a favorable neurologic outcome, as compared with 10 patients (16%) in the conventional-CPR group (odds ratio, 1.4; 95% confidence interval, 0.5 to 3.5; P = 0.52). The number of serious adverse events per patient was similar in the two groups.
CONCLUSIONS: In patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR and conventional CPR had similar effects on survival with a favorable neurologic outcome. (Funded by the Netherlands Organization for Health Research and Development and Maquet Cardiopulmonary [Getinge]; INCEPTION ClinicalTrials.gov number, NCT03101787.).