Low-flow time is associated with a favorable neurological outcome in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation

Abstract

ProposeThe aim of this retrospective study was to investigate the prognostic factors in extracorporeal cardiopulmonary resuscitation (ECPR) patients and to assess their accuracy as predictors of a favorable neurological outcome. Materials and methodsBetween October 2009 and December 2017, we retrospectively analyzed witnessed out-of-hospital cardiac arrest patients who were admitted to our hospital and resuscitated with ECPR. We compared the baseline characteristics, pre-hospital clinical course, arrest causes, and blood samples on admission for the favorable and unfavorable outcome groups. ResultsAmong the 135 patients included, 22 (16%) had a favorable neurological outcome. Low-flow time was shorter (median 38 vs. 48 min, p < 0.001) in the favorable neurological outcome group; in multiple logistic analyses, low-flow time was significantly associated with a favorable neurological outcome (odds ratio, 0.88; 95% confidence interval, 0.82–0.94). The area under the receiver-operating characteristic curve of low-flow time was 0.80 (95% confidence interval, 0.70–0.89), and the cut-off value of 58 min corresponded to a sensitivity of 0.25 and a specificity of 1.0. ConclusionsIn ECPR patients, low-flow time was significantly associated with a favorable neurological outcome, and ECPR should be performed within 58 min of the low-flow time.