Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan

Okada, Yohei; Kiguchi, Takeyuki; Irisawa, Taro; Yoshiya, Kazuhisa; Yamada, Tomoki; Hayakawa, Koichi; Noguchi, Kazuo; Nishimura, Tetsuro; Ishibe, Takuya; Yagi, Yoshiki; Kishimoto, Masafumi; Shintani, Hiroshi; Hayashi, Yasuyuki; Sogabe, Taku; Morooka, Takaya; Sakamoto, Haruko; Suzuki, Keitaro; Nakamura, Fumiko; Nishioka, Norihiro; Matsuyama, Tasuku; Sado, Junya; Matsui, Satoshi; Shimazu, Takeshi; Koike, Kaoru; Kawamura, Takashi; Kitamura, Tetsuhisa; Iwami, Taku

doi:https://doi.org/10.1186/s40560-020-00451-6

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan

Okada, Yohei; Kiguchi, Takeyuki; Irisawa, Taro et al.

Journal of Intensive Care, 2020, 8, 34

アクセス数:3,105件（2025-10-24 11:46 集計）

固定URL: https://hdl.handle.net/11094/78373

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タイトル	Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan
著者	著者名 Okada, Yohei
	NRID 1000030724380 1000030724380 著者名 Kiguchi, Takeyuki
	NRID 1000050379202 1000050379202 researchmap permalink taroiri taroiri Scopus Author ID 7006596493 7006596493 著者名 Irisawa, Taro
	NRID 1000040379201 1000040379201 著者名 Yoshiya, Kazuhisa
	NRID 1000040623434 1000040623434 著者名 Yamada, Tomoki
	NRID 1000060403086 1000060403086 著者名 Hayakawa, Koichi
	著者名 Noguchi, Kazuo
	著者名 Nishimura, Tetsuro
	著者名 Ishibe, Takuya
	著者名 Yagi, Yoshiki
	著者名 Kishimoto, Masafumi
	著者名 Shintani, Hiroshi
	著者名 Hayashi, Yasuyuki
	著者名 Sogabe, Taku
	著者名 Morooka, Takaya
	著者名 Sakamoto, Haruko
	著者名 Suzuki, Keitaro
	著者名 Nakamura, Fumiko
	著者名 Nishioka, Norihiro
	NRID 1000050829025 1000050829025 著者名 Matsuyama, Tasuku
	著者名 Sado, Junya
	著者名 Matsui, Satoshi
	NRID 1000050196474 1000050196474 著者名 Shimazu, Takeshi
	NRID 1000010267164 1000010267164 著者名 Koike, Kaoru
	NRID 1000010252230 1000010252230 著者名 Kawamura, Takashi
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 Kitamura, Tetsuhisa
	NRID 1000060437291 1000060437291 著者名 Iwami, Taku
キーワード等	Blood gas assessment
	Extracorporeal life support
	Extracorporeal membrane oxygenation (ECMO)
	Percutaneous cardiopulmonary support (PCPS)
	Ventricular fibrillation
内容	Okada, Y., Kiguchi, T., Irisawa, T. et al. Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan. j intensive care 8, 34 (2020). https://doi.org/10.1186/s40560-020-00451-6
抄録	Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875-7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10-0.63) and 0.24 (95% CI 0.09-0.61), respectively. Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.
出版者	BioMed Central Ltd.
収録物名	Journal of Intensive Care
巻(号)	8
ページ	34
刊行年月	2020-05-11
言語	英語
ハンドルURL	https://hdl.handle.net/11094/78373
eISSN	20520492
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1186/s40560-020-00451-6
アクセス権	open access
権利情報	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Journal of Intensive Care. 2020, 8, p. 34
DC.title	Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan
DC.creator	Okada, Yohei
	Kiguchi, Takeyuki
	Irisawa, Taro
	Yoshiya, Kazuhisa
	Yamada, Tomoki
	Hayakawa, Koichi
	Noguchi, Kazuo
	Nishimura, Tetsuro
	Ishibe, Takuya
	Yagi, Yoshiki
	Kishimoto, Masafumi
	Shintani, Hiroshi
	Hayashi, Yasuyuki
	Sogabe, Taku
	Morooka, Takaya
	Sakamoto, Haruko
	Suzuki, Keitaro
	Nakamura, Fumiko
	Nishioka, Norihiro
	Matsuyama, Tasuku
	Sado, Junya
	Matsui, Satoshi
	Shimazu, Takeshi
	Koike, Kaoru
	Kawamura, Takashi
	Kitamura, Tetsuhisa
	Iwami, Taku
DC.publisher	BioMed Central Ltd.
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-05-11
DC.identifier	https://doi.org/10.1186/s40560-020-00451-6
DC.subject	Blood gas assessment
	Extracorporeal life support
	Extracorporeal membrane oxygenation (ECMO)
	Percutaneous cardiopulmonary support (PCPS)
	Ventricular fibrillation
DC.description	Okada, Y., Kiguchi, T., Irisawa, T. et al. Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan. j intensive care 8, 34 (2020). https://doi.org/10.1186/s40560-020-00451-6
DCTERMS.abstract	Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875-7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10-0.63) and 0.24 (95% CI 0.09-0.61), respectively. Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.
DC.rights	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	78373
citation_title	Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan
citation_author	Okada, Yohei
	Kiguchi, Takeyuki
	Irisawa, Taro
	Yoshiya, Kazuhisa
	Yamada, Tomoki
	Hayakawa, Koichi
	Noguchi, Kazuo
	Nishimura, Tetsuro
	Ishibe, Takuya
	Yagi, Yoshiki
	Kishimoto, Masafumi
	Shintani, Hiroshi
	Hayashi, Yasuyuki
	Sogabe, Taku
	Morooka, Takaya
	Sakamoto, Haruko
	Suzuki, Keitaro
	Nakamura, Fumiko
	Nishioka, Norihiro
	Matsuyama, Tasuku
	Sado, Junya
	Matsui, Satoshi
	Shimazu, Takeshi
	Koike, Kaoru
	Kawamura, Takashi
	Kitamura, Tetsuhisa
	Iwami, Taku
citation_publisher	BioMed Central Ltd.
citation_language	英語
citation_date	2020-05-11
citation_journal_title	Journal of Intensive Care
citation_volume	8
citation_firstpage	34
citation_doi	https://doi.org/10.1186/s40560-020-00451-6
citation_public_url	https://hdl.handle.net/11094/78373

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: A prospective observational cohort study in Japan

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