Evidence map›Paper›PMID 38438853›Full record

Observational studyBMC emergency medicine2024

Prognostic effects of cardiopulmonary resuscitation (CPR) start time and the interval between CPR to extracorporeal cardiopulmonary resuscitation (ECPR) on patient outcomes under extracorporeal membrane oxygenation (ECMO): a single-center, retrospective observational study.

Amir Vahedian-Azimi, Ibrahim Fawzy Hassan, Farshid Rahimi-Bashar, Hussam Elmelliti, Mahmood Salesi, Hazim Alqahwachi, Fatima Albazoon, Anzila Akbar, Ahmed Labib Shehata, Abdulsalam Saif Ibrahim and 1 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
5.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Amir Vahedian-AzimiTrauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.ORCID 0000-0002-1678-7608
Ibrahim Fawzy HassanMedical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.ORCID 0000-0002-0283-125X
Farshid Rahimi-BasharDepartment of Anesthesiology and Critical Care, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran.ORCID 0000-0001-8276-1425
Hussam ElmellitiEmergency Department, Hamad General Hospital, Doha, Qatar.ORCID 0000-0002-5394-3120
Mahmood SalesiChemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.ORCID 0000-0003-3042-2143
Hazim AlqahwachiMedical Education, Hamad Medical Corporation, Doha, Qatar.
Fatima AlbazoonMedical Research Center, Hamad Medical Corporation, Doha, Qatar.
Anzila AkbarTrauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Ahmed Labib ShehataMedical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.ORCID 0000-0003-1863-0484
Abdulsalam Saif IbrahimMedical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
Ali Ait HssainMedical Intensive Care Unit, Hamad General Hospital, Doha, Qatar. A_aithssain@hotmail.com.ORCID 0000-0002-7764-5793
Hamad General Hospital · QABaqiyatallah University of Medical Sciences · IRHamad Medical Corporation · QAHamedan University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of the chronological sequence of events, including cardiac arrest (CA), initial cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), and extracorporeal cardiopulmonary resuscitation (ECPR) implementation, on clinical outcomes in patients with both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), is still not clear. The aim of this study was to investigate the prognostic effects of the time interval from collapse to start of CPR (no-flow time, NFT) and the time interval from start of CPR to implementation of ECPR (low-flow time, LFT) on patient outcomes under Extracorporeal Membrane Oxygenation (ECMO).

methodsThis single-center, retrospective observational study was conducted on 48 patients with OHCA or IHCA who underwent ECMO at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. We investigated the impact of prognostic factors such as NFT and LFT on various clinical outcomes following cardiac arrest, including 24-hour survival, 28-day survival, CPR duration, ECMO length of stay (LOS), ICU LOS, hospital LOS, disability (assessed using the modified Rankin Scale, mRS), and neurological status (evaluated based on the Cerebral Performance Category, CPC) at 28 days after the CA.

resultsThe results of the adjusted logistic regression analysis showed that a longer NFT was associated with unfavorable clinical outcomes. These outcomes included longer CPR duration (OR: 1.779, 95%CI: 1.218-2.605, P = 0.034) and decreased survival rates for ECMO at 24 h (OR: 0.561, 95%CI: 0.183-0.903, P = 0.009) and 28 days (OR: 0.498, 95%CI: 0.106-0.802, P = 0.011). Additionally, a longer LFT was found to be associated only with a higher probability of prolonged CPR (OR: 1.818, 95%CI: 1.332-3.312, P = 0.006). However, there was no statistically significant connection between either the NFT or the LFT and the improvement of disability or neurologically favorable survival after 28 days of cardiac arrest.

conclusionsBased on our findings, it has been determined that the NFT is a more effective predictor than the LFT in assessing clinical outcomes for patients with OHCA or IHCA who underwent ECMO. This understanding of their distinct predictive abilities enables medical professionals to identify high-risk patients more accurately and customize their interventions accordingly.

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationOut-of-Hospital Cardiac ArrestHospitals, GeneralHumansPrognosisCardiac arrestCardiopulmonary resuscitationExtracorporeal circulationExtracorporeal membrane oxygenation out-of-hospital cardiac arrestIn-hospital cardiac arrestPrognosis

Identifiers

PMID38438853
PMCPMC10913290
OpenAlexW4392620618

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.