Abstract
Aim
To investigate the effect of intra-aortic balloon pump (IABP) use after extracorporeal
membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) on short-term neurological
outcomes and survival in patients with out-of-hospital cardiac arrest (OHCA).
Methods
We retrospectively analysed data collected between June 2014 and December 2019 from
the Japanese OHCA registry. Adult patients (aged ≥18 years) who underwent ECPR were
included. We divided the patients into those who received IABP and those who did not
receive IABP. The primary outcome was the 30-day favourable neurological outcomes
in survived patients. The secondary outcome was the 30-day survival. We performed
propensity score matching (PSM) to adjust for confounding factors after multiple imputations
of missing data. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were
estimated using logistic regression analysis after PSM to adjust for confounding factors
after IABP initiation.
Results
Among 2135 adult patients who underwent ECPR, 1173 received IABP. In 842 matched patients,
IABP use was associated with survival (aOR, 1.98; 95% CI, 1.39–2.83; p < 0.001). However, IABP use was not significantly associated with the 30-day neurologically
favourable outcome in 190 survived patients (aOR, 1.22; 95% CI, 0.79–1.89; p = 0.36).
Conclusion
The use of IABP in patients with OHCA who underwent ECPR was associated with 30-day
survival. Among survived patients, there was no significant association between IABP
use and 30-day neurological outcome. A further well-designed prospective study is
needed.
Keywords
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Article info
Publication history
Published online: December 05, 2022
Accepted:
November 29,
2022
Received in revised form:
November 7,
2022
Received:
May 2,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
