ArticleResuscitation plus2025
Characteristics of patients requiring tracheostomy following extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest.
Article in Resuscitation plus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: This study aimed to describe the characteristics of patients requiring tracheostomy following extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) using real-world data from a multicenter registry. Methods: This was a secondary analysis of the SAVE-J II study, a retrospective multicenter registry study in Japan. Patients with OHCA aged ≥18 years who underwent ECPR between January 2013 and December 2018 were included. Participants were classified into the tracheostomy and non-tracheostomy groups, with the tracheostomy group further categorized into early (≤10 days) and late (>10 days) subgroups. Survival and favorable neurological outcome at hospital discharge were the primary outcomes. Results: Overall, this study included 1,910 patients with a median age of 61 (interquartile range [IQR], 49-69) years, of whom 1,610 (82.6%) were male. Of the participants, 276 (14.5%) underwent tracheostomy, with 224 (81.2%) and 44 (15.9%) surviving to discharge and achieving favorable neurological outcomes at hospital discharge, respectively. The median duration to tracheostomy was 10 (IQR, 8-14) days, with 98% of tracheostomies performed following extracorporeal membrane oxygenation (ECMO) weaning. The early tracheostomy group accounted for 145 patients (54.7%). The early and late tracheostomy subgroups showed no significant differences in survival or favorable neurological outcomes at discharge. Conclusions: Following ECPR, 14.5% of the patients underwent tracheostomy, with the majority performed following ECMO weaning. Although the survival rate at discharge among these patients was 81.2%, only 15.9% exhibited favorable neurological outcomes. To explore the long-term outcomes of patients treated with ECPR for OHCA, future studies are needed.
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