Research groups at Kyoto Prefectural University of Medicine and Osaka University have found that early introduction of extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest whose self-heartbeat has not resumed due to conventional life-saving procedures is related to improving the rate of reintegration into society. Showed for the first time to do.
Extracorporeal circulation cardiopulmonary resuscitation is a cardiopulmonary resuscitation method using an extracorporeal circulation type heart-lung machine that oxygenates inflow blood using an artificial lung and a pump.The usefulness of this resuscitation method for patients with cardiac arrest who do not respond to conventional cardiopulmonary resuscitation has been attracting attention in recent years, but the appropriate introduction method has been a major issue in the international cardiopulmonary resuscitation guidelines.
The research group focused on the low perfusion time (the period from the start of cardiopulmonary resuscitation until sufficient organ blood flow is obtained), which is a particularly important condition among the conditions for introducing extracorporeal CPR.Furthermore, the effect of this low perfusion time was analyzed in consideration of the electrocardiogram waveform of a patient with cardiac arrest during resuscitation, which is another important condition.
This time, we used data (2-14) of 256 adults registered as out-of-hospital cardiac arrest patients by 2012 critical care centers and secondary emergency hospitals in Osaka Prefecture.For all patients, the low perfusion time until the start of extracorporeal CPR was divided into a short-time group (2016-24 minutes), a medium-time group (45-46 minutes), and a long-time group (57-58 minutes). The return rate was 117% (22.0 out of 100), 22% (17.1 out of 82), and 14% (6.8 out of 74), respectively.In addition, the effect of early introduction was great when the ventricular fibrillation (a type of arrhythmia) waveform, which is an indication for electric shock, persists during cardiopulmonary arrest, and when the low perfusion time is prolonged.
The results of this study are expected to contribute to the revision of the international cardiopulmonary resuscitation guidelines as evidence for improving the resuscitation rate of patients with out-of-hospital cardiac arrest by providing an index for introducing limited resources at an appropriate time.
