Recently, people have paid attention to ECPR (Extracorporeal cardiopulmonary resuscitation), which uses Extracorporeal membrane oxygenation (ECMO) to resuscitate cardiac arrest patients. However, each area brings the strategy of ECPR into practice differently. For instance, in Osaka, ECPR is provided to thirty to sixty percent of cardiac arrest patients with an initial shockable rhythm. On the other hand, less than one percent of the patients are provided with ECPR in Singapore. Dr. Yohei Okada and Professor Taku Iwami from Department of Preventive Services cooperated with Professor Marcus Ong from Duke-NUS Medical School in Singapore focused on this difference and investigated whether there is a difference in the outcome of out-of-hospital cardiac arrest patients with an initial shockable rhythm.
In this research, Dr. Okada and his colloborators adopted a prediction model induced from the database of out-of-hospital cardiac arrest in Osaka called Osaka-CRITICAL study to 1,789 out-of-hospital cardiac arrest patients with an initial shockable rhythm registered in Singaporean database, SG-PAROS. They showed that patients who recovered from cardiac arrest on hospital arrival, had similar favorable neurological outcome compared to the prediction from model based on the data in Osaka (the observed–expected ratio (OE ratio): 0.905 [95%CI: 0.784–1.036]). On the other hand, they found that patients who continued to undergo cardiac arrest on hospital arrival, had lower outcome than expected from the data in Osaka. (OE ratio among patients with shockable rhythm on hospital arrival: 0.369 [95％CI：0.258-0.499], OE ratio among patients with nonshockable rhythm on hospital arrival: 0.137 [95％CI：0.065-0.235]).
This research showed how resuscitation strategy including ECPR could influence on society. It is expected that by introducing ECPR strategy, out-of-hospital cardiac arrest patients in Singapore could have more favorable outcome.
This research was published online in The Journal of Critical Care (Impact factor 15.1) on September 12th, 2023.
Okada, Y., Shahidah, N., Ng, Y.Y. et al. Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm. Crit Care 27, 351 (2023).
Outcome assessment for out-of-hospital cardiac arrest patients in Singapore and Japan with initial shockable rhythm – Critical Care