Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis
Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis
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DOI：
10.1016/s0140-6736(08)60958-7
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发表时间：
2008-08-16
期刊：
影响因子：
168.9
通讯作者：
Lin, Fang-Yue
中科院分区：
文献类型：
--
作者：
Chen, Yih-Sharng;Lin, Jou-Wei;Lin, Fang-Yue
体外生命支持作为心脏复苏的辅助手段，在心脏骤停患者中显示出令人鼓舞的结果。然而，与传统的心肺复苏术（CPR）相比，几乎没有证据表明该手术的益处，特别是当持续时间超过10分钟时。我们的目的是评估体外心肺复苏术是否优于传统的心肺复苏术，用于医院心源性心脏骤停患者。方法我们对18岁至18岁的患者进行了为期3年的前瞻性观察研究。75岁，与接受常规CPR的患者相比，在医院目睹了心源性心脏骤停，接受CPR超过10分钟。基于倾向评分进行匹配过程，以均衡两组中的潜在预后因素，并制定平衡的1：1匹配队列研究。主要终点是出院时的生存率，分析是通过意向治疗进行的。该研究在ClinicalTrials.gov注册，编号NCT00173615。结果在975例接受CPR超过10分钟的院内心脏骤停事件患者中，113例入选常规CPR组，59例入选体外CPR组。接受体外心肺复苏术的不匹配患者出院存活率较高（对数秩检验p
Background Extracorporeal life-support as an adjunct to cardiac resuscitation has shown encouraging outcomes in patients with cardiac arrest. However, there is little evidence about the benefit of the procedure compared with conventional cardiopulmonary resuscitation (CPR), especially when continued for more than 10 min. We aimed to assess whether extracorporeal CPR was better than conventional CPR for patients with in-hospital cardiac arrest of cardiac origin.Methods We did a 3-year prospective observational study on the use of extracorporeal life-support for patients aged 18-75 years with witnessed in-hospital cardiac arrest of cardiac origin undergoing CPR of more than 10 min compared with patients receiving conventional CPR. A matching process based on propensity-score was done to equalise potential prognostic factors in both groups, and to formulate a balanced 1:1 matched cohort study. The primary endpoint was survival to hospital discharge, and analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00173615.Findings Of the 975 patients with in-hospital cardiac arrest events who underwent CPR for longer than 10 min, 113 were enrolled in the conventional CPR group and 59 were ertrolled in the extracorporeal CPR group. Unmatched patients who underwent extracorporeal CPR had a higher survival rate to discharge (log-rank p