• Mamoru Hase, Kazufumi Tsuchihashi, Noriyuki Fujii, Kimio Nishizato, Nobuaki Kokubu, Satoshi Nara, Yoshihiko Kurimoto, Akiyoshi Hashimoto, Kikuya Uno, Tetsuji Miura, Nobuyuki Ura, Yasufumi Asai, and Kazuaki Shimamoto.
• Division of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. hase@sapmed.ac.jp
• Circ. J. 2005 Nov 1;69(11):1302-7.

BackgroundEarly defibrillation and cardiopulmonary bypass have been postulated to be a promising intervention against out-of-hospital cardiac arrest (OHCA); however, little is known about the long-term prognosis. The effects of early recovery of circulation (ROC) on neurological recovery and the long-term outcome in patients with OHCA were examined.Methods And ResultsFunctional recovery and long-term (22.0+/-15.3 months) outcome were examined in 100 patients with definite diagnosis of OHCA. Spontaneous circulation recovered in 79% of the patients (using on-site counter shock in 20% of the patients). Cardiopulmonary bypass was performed in 38 of the OHCA patients. The total survival and favorable neurological recovery rates were 40% and 25%, respectively. The patients with favorable recovery obtained early ROC (28.2+/-16.0 min). Receiver-operating characteristic analysis showed that a period of less than 35 min for ROC was the optimal period for achieving a favorable recovery, with sensitivity of 68% and specificity of 73%. The patients with a prior history of heart failure or reduced left ventricular ejection fraction exhibited more frequent, exacerbated heart failure and ventricular arrhythmias.ConclusionsEarly ROC using on-site counter shock or cardiopulmonary bypass might result in better long-term outcome in patients with OHCA of cardiac origin.

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