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

Number of Access:3,308（2025-12-11 22:39 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78373

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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
Creator	CreatorName Okada, Yohei
	NRID 1000030724380 1000030724380 CreatorName Kiguchi, Takeyuki
	NRID 1000050379202 1000050379202 researchmap permalink taroiri taroiri Scopus Author ID 7006596493 7006596493 CreatorName Irisawa, Taro
	NRID 1000040379201 1000040379201 CreatorName Yoshiya, Kazuhisa
	NRID 1000040623434 1000040623434 CreatorName Yamada, Tomoki
	NRID 1000060403086 1000060403086 CreatorName Hayakawa, Koichi
	CreatorName Noguchi, Kazuo
	CreatorName Nishimura, Tetsuro
	CreatorName Ishibe, Takuya
	CreatorName Yagi, Yoshiki
	CreatorName Kishimoto, Masafumi
	CreatorName Shintani, Hiroshi
	CreatorName Hayashi, Yasuyuki
	CreatorName Sogabe, Taku
	CreatorName Morooka, Takaya
	CreatorName Sakamoto, Haruko
	CreatorName Suzuki, Keitaro
	CreatorName Nakamura, Fumiko
	CreatorName Nishioka, Norihiro
	NRID 1000050829025 1000050829025 CreatorName Matsuyama, Tasuku
	CreatorName Sado, Junya
	CreatorName Matsui, Satoshi
	NRID 1000050196474 1000050196474 CreatorName Shimazu, Takeshi
	NRID 1000010267164 1000010267164 CreatorName Koike, Kaoru
	NRID 1000010252230 1000010252230 CreatorName 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 CreatorName Kitamura, Tetsuhisa
	NRID 1000060437291 1000060437291 CreatorName Iwami, Taku
Subject	Blood gas assessment
	Extracorporeal life support
	Extracorporeal membrane oxygenation (ECMO)
	Percutaneous cardiopulmonary support (PCPS)
	Ventricular fibrillation
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
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.
Publisher	BioMed Central Ltd.
Source Title	Journal of Intensive Care
Volume (Issue)	8
Page	34
Date of Issued	2020-05-11
Language	English
Handle URL	https://hdl.handle.net/11094/78373
eISSN	20520492
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s40560-020-00451-6
Access Rights	open access
CopyRight	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	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	English
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	English
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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