What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study

• Published in: International journal of emergency medicine Vol. 17; no. 1; pp. 56 - 9
• Main Authors: Vahedian-Azimi, Amir, Hassan, Ibrahim Fawzy, Rahimi-Bashar, Farshid, Elmelliti, Hussam, Akbar, Anzila, Shehata, Ahmed Labib, Ibrahim, Abdulsalam Saif, Ait Hssain, Ali
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 17-04-2024; Springer Nature B.V; BMC
• Subjects: Age groups; Angiology; Cardiac arrest; Cardiology; Cardiopulmonary resuscitation; Clinical outcomes; Comorbidity; CPR; Emergency medical care; Emergency Medicine; Extracorporeal cardiopulmonary resuscitation; Health risks; In-hospital cardiac arrest; Internal Medicine; Lifesaving; Medicine; Medicine & Public Health; Out-of-hospital cardiac arrest; Pediatrics; Prognostic factors; Out-of-hospital cardiac arrest; In-hospital cardiac arrest; Cardiopulmonary resuscitation; Prognostic factors; Extracorporeal cardiopulmonary resuscitation; Cardiac arrest
• ISSN: 1865-1380; 1865-1372; 1865-1380
• DOI: 10.1186/s12245-024-00608-2

Background
Extracorporeal cardiopulmonary resuscitation (ECPR) is an alternative method for patients with reversible causes of cardiac arrest (CA) after conventional cardiopulmonary resuscitation (CCPR). However, cardiopulmonary resuscitation (CPR) duration during ECPR can vary due to multiple factors. Healthcare providers need to understand these factors to optimize the resuscitation process and improve outcomes. The aim of this study was to examine the different variables impacting the duration of CPR in patients undergoing ECPR.
Methods
This retrospective, single-center, observational study was conducted on adult patients who underwent ECPR due to in-hospital CA (IHCA) or out-of-hospital CA (OHCA) at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. Univariate and multivariate binary logistic regression analyses were performed to identify the prognostic factors associated with CPR duration, including demographic and clinical variables, as well as laboratory tests.
Results
The mean ± standard division age of the 48 participants who underwent ECPR was 41.50 ± 13.15 years, and 75% being male. OHCA and IHCA were reported in 77.1% and 22.9% of the cases, respectively. The multivariate analysis revealed that several factors were significantly associated with an increased CPR duration: higher age (OR: 1.981, 95%CI: 1.021–3.364,
P
 = 0.025), SOFA score (OR: 3.389, 95%CI: 1.289–4.911,
P
 = 0.013), presence of comorbidities (OR: 3.715, 95%CI: 1.907–5.219,
P
 = 0.026), OHCA (OR: 3.715, 95%CI: 1.907–5.219,
P
 = 0.026), and prolonged collapse-to-CPR time (OR: 1.446, 95%CI:1.092–3.014,
P
 = 0.001). Additionally, the study found that the initial shockable rhythm was inversely associated with the duration of CPR (OR: 0.271, 95%CI: 0.161–0.922,
P
 = 0.045). However, no significant associations were found between laboratory tests and CPR duration.
Conclusion
These findings suggest that age, SOFA score, comorbidities, OHCA, collapse-to-CPR time, and initial shockable rhythm are important factors influencing the duration of CPR in patients undergoing ECPR. Understanding these factors can help healthcare providers better predict and manage CPR duration, potentially improving patient outcomes. Further research is warranted to validate these findings and explore additional factors that may impact CPR duration in this population.