Which patients benefit from transport with ongoing cardiopulmonary resuscitation? : Retrospective analysis of 70patients with refractory preclinical cardiac arrest

Abstract

Mortality in patients with out-of-hospital cardiac arrest (OHCA) remains very high despite advances in resuscitation algorithms. Most of these patients die at the scene and do not reach hospital. It is currently the subject of discussion whether transport to hospital with ongoing cardiopulmonary resuscitation (CPR) improves survival and neurological outcome in patients with OHCA. The aim of this study was to identify predictors of survival and good neurological outcome in patients after OHCA who were transported to hospital with ongoing CPR. Atotal of 70consecutive patients with refractory OHCA (mean age 54.7 ± 15years) transported to hospital with ongoing CPR were retrospectively analyzed. Neurological outcome was assessed after 30days based on the Glasgow-Pittsburgh cerebral performance category (CPC). After 30days 82.9% of the patients enrolled in the trial died (CPC score of5), 8patients (11.4%) showed agood neurological recovery with CPC scores of 1-2 and 4patients (5.7%) had apoor neurological outcome with CPC scores of 3-4. Predictors of good neurological outcome were witnessed arrest, initial defibrillatable rhythm and serum lactate levels on admission. In all patients with good outcome, the index event for OHCA was from cardiac causes. Selected patient collectives can benefit from transport to hospital with ongoing cardiopulmonary resuscitation (CPR).