Impact of early invasive blood pressure monitoring on outcomes in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation
10.3760/cma.j.cn114656-20241122-00812
- VernacularTitle:早期血压监测和干预对院外心搏骤停体外心肺复苏患者结局的影响
- Author:
Xiaodong SONG
1
;
Mingjun HUANG
;
Jun LI
;
Hang GUO
;
Yao LUO
;
Jin TAO
;
Yuepeng HU
;
Qiang ZHANG
;
Xinya JIA
;
Liu YANG
;
Tangjuan ZHANG
;
Dongqing DOU
;
Jianliang CAO
;
Hui ZHAO
;
Genglei CAO
;
Yabai KAN
;
Xingxing LI
;
Chao LAN
Author Information
1. 郑州大学第一附属医院郑东院区急救中心，郑州 450046
- Keywords:
Extracorporeal membrane oxygenation;
Out-of-hospital cardiac arrest;
Extracorporeal cardiopulmonary resuscitation;
Early invasive blood pressure monitori
- From:
Chinese Journal of Emergency Medicine
2025;34(7):932-939
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.
