Adult Cardiac

Honzawa, Hiroshi1,2; Taniguchi, Hayato2; Abe, Takeru2; Oi, Yasufumi1; Ogawa, Fumihiro1; Takeuchi, Ichiro2

1Department of Emergency Medicine, Yokohama City University Hospital, Yokohama, Japan.

2Yokohama City University Medical Center for Advanced Critical Care and Emergency Medicine, Yokohama, Japan

Background: Currently, the effect of prophylactic distal perfusion catheter insertion after extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) remains unclear. Therefore, we aimed to clarify the association between prophylactic distal perfusion catheter insertion and prognosis in patients with OHCA undergoing ECPR.

Methods: A secondary analysis of the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J II) database was performed to compare the groups with or without prophylactic distal perfusion catheter. A multivariable analysis of survival at discharge was performed using factors that were significant in the two-arm comparison.

Results: A total of 2,044 patients were included in the analysis after excluding those who adjusted the exclusion criteria. Survival at discharge was observed in 548 patients (26.9%). One hundred patients (4.9%) developed lower extremity ischemia, and 14 patients (0.7%) required therapeutic intervention for lower extremity ischemia. There was no significant association between survival at discharge and prophylactic distal perfusion catheter insertion (odds ratio [95% confidence interval]: 0.90 [0.65–1.24], p = 0.509).

Conclusion: The implementation of prophylactic distal perfusion catheter insertion after ECPR for patients with OHCA may not contribute to the survival at discharge. A further study is needed to determine in which cases prophylactic distal perfusion catheter insertion is useful.