医学
体外膜肺氧合
体外心肺复苏
倾向得分匹配
心肺复苏术
优势比
混淆
目标温度管理
主动脉内球囊反搏
内科学
复苏
置信区间
心脏病学
外科
主动脉内球囊反搏
自然循环恢复
心肌梗塞
心源性休克
作者
Masahiro Kashiura,Yuki Kishihara,Hidechika Ozawa,Shunsuke Amagasa,Hideto Yasuda,Takuya Moriya
出处
期刊:Resuscitation
[Elsevier]
日期:2023-01-01
卷期号:182: 109660-109660
标识
DOI:10.1016/j.resuscitation.2022.11.026
摘要
To investigate the effect of intra-aortic balloon pump (IABP) use after extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) on short-term neurological outcomes and survival in patients with out-of-hospital cardiac arrest (OHCA).We retrospectively analysed data collected between June 2014 and December 2019 from the Japanese OHCA registry. Adult patients (aged ≥18 years) who underwent ECPR were included. We divided the patients into those who received IABP and those who did not receive IABP. The primary outcome was the 30-day favourable neurological outcomes in survived patients. The secondary outcome was the 30-day survival. We performed propensity score matching (PSM) to adjust for confounding factors after multiple imputations of missing data. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression analysis after PSM to adjust for confounding factors after IABP initiation.Among 2135 adult patients who underwent ECPR, 1173 received IABP. In 842 matched patients, IABP use was associated with survival (aOR, 1.98; 95% CI, 1.39-2.83; p < 0.001). However, IABP use was not significantly associated with the 30-day neurologically favourable outcome in 190 survived patients (aOR, 1.22; 95% CI, 0.79-1.89; p = 0.36).The use of IABP in patients with OHCA who underwent ECPR was associated with 30-day survival. Among survived patients, there was no significant association between IABP use and 30-day neurological outcome. A further well-designed prospective study is needed.
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