Cardiac arrest & resuscitation
Cardiac Rhythm Conversions and the Outcome in Refractory Out-of-Hospital Cardiac Arrest: Extracorporeal Versus Conventional Resuscitation
Authors' conclusion
Achieving ROSC is the best prognostic marker in OHCA patients with an initially refractory VF. Patients with intermittent ROSC after the initial VF and ongoing VF seem to be optimal candidates for an invasive approach. Asystole detection at any time during resuscitation is a strong negative prognostic marker, irrespective of the initial rhythm.
Study context
- Population
- Patients with refractory OHCA randomised in the Prague OHCA study (median age 58, 17% females)
- Participants
- 256 patients
- Comparison
- Invasive vs Conventional
- Primary endpoint
- Composite of survival with Cerebral Performance Category 1 or 2
- Follow-up
- 180 days
Primary result
As reported in the abstract
Initial ventricular fibrillation (VF) with sustained recovery of spontaneous circulation (ROSC): highest proportion reaching primary outcome
32 of 44
73%
≥1 episode of asystole during CPR: lowest rate of primary endpoint
5 of 39
13%
Further findings
Survival with CPC 1 or 2, patients with intermittent ROSC (subgroup) · 180 days
P < 0.05
- Survival with CPC 1 or 2, patients with intermittent ROSC (subgroup): 26/34 vs 24/50
Initial rhythm
- VF
- 156 (61%)
- Pulseless electrical activity
- 45
- Asystole
- 55
Original publication
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