Pneumonia and Extracorporeal Cardiopulmonary Resuscitation Followed by Targeted Temperature Management in Patients With Out-of-Hospital Cardiac Arrest　― Retrospective Cohort Study ―

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  • Shiba Daiki
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Hifumi Toru
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Tsuchiya Makiko
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Hattori Kenji
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Kawakami Naoki
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Shin Kijong
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Fukazawa Nozomi
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Horie Katsuhiro
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Watanabe Yu
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Ishikawa Yohei
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Shimizu Masato
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Isokawa Shutaro
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Toya Nozomi
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Iwasaki Tsutomu
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Otani Norio
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Ishimatsu Shinichi
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital

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Abstract

<p>Background:We examined the association between initiation of extracorporeal cardiopulmonary resuscitation (ECPR) and the incidence of infectious complications, such as pneumonia, sepsis, and bacteremia, after out-of-hospital cardiac arrest (OHCA) in patients who received targeted temperature management (TTM).</p><p>Methods and Results:This retrospective study used data from hospital medical records of patients with OHCA treated with TTM who had been admitted to St. Luke’s International Hospital between April 2006 and December 2018. The primary endpoint was the association between the type of CPR and the incidence of early onset pneumonia in the intensive care unit (ICU; between 48 h and 7 days of hospitalization). Univariate and multivariate logistic regression analyses were performed for the primary endpoints. After applying the inclusion/exclusion criteria, 254 patients were included in the analyses; of these, 52 were enrolled in the ECPR group, and 202 were enrolled in the CCPR group. Median age was 58 years, 88.5% were male, prophylactic antibiotics were used in 80.3%, and favorable neurological outcomes were observed in 51.9%. On multivariate analysis, ECPR (odds ratio [OR], 2.78; 95% CI: 1.16–6.66; P=0.037) was significantly associated with the development of early onset pneumonia.</p><p>Conclusions:ECPR was an independent predictor of pneumonia after OHCA in patients who received TTM.</p>

Journal

  • Circulation Reports

    Circulation Reports 1 (12), 575-581, 2019-12-10

    The Japanese Circulation Society

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