Time Interval from Intubation to Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest Patient with Brain Hemorrhage

Baek, Sumin; Jung, Euigi; Shin, Jonghwan; Lee, Hui Jai; Lee, Se Jong; You, Kyoung Min; Kim, Kyuseok; Jo, You Hwan; Lee, Jae Hyuk; Kim, Joonghee

J Korean Soc Emerg Med > Volume 29(1); 2018 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2018;29(1): 57-65.

Time Interval from Intubation to Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest Patient with Brain Hemorrhage

Sumin Baek¹, Euigi Jung¹, Jonghwan Shin¹, Hui Jai Lee¹, Se Jong Lee¹, Kyoung Min You¹, Kyuseok Kim², You Hwan Jo², Jae Hyuk Lee², Joonghee Kim²

¹Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
²Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence

Euigi Jung ,Tel: 02-870-2667, Fax: 02-831-0714, Email: nicedoctor00@gmail.com,

Received: October 12, 2017; Revised: October 12, 2017 Accepted: November 19, 2017. Published online: February 28, 2018.

ABSTRACT

Purpose:
This study was conducted to investigate the relationship of time interval from intubation to return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients according to the presence or absence of intracranial hemorrhage (ICH).
Method:
This retrospective study used data from a prospectively collected OHCA registry for patients treated from January 2008 to December 2016. Non-traumatic adult OHCA patients who underwent brain computed tomography were included, while patients who achieved a prehospital ROSC or required advanced airway management were excluded. Utstein variables, initial blood gas analysis, electrolyte levels, and the time interval from intubation to ROSC were used to compare the ICH and non-ICH groups.
Results
A total of 448 patients were analyzed. The ICH group was younger and had more females than the non-ICH group. The time interval from intubation to ROSC was significantly shorter in the ICH group than the non-ICH group. The median time and interquartile range were 3 (2 to 7) minutes in the ICH group and 6 (3 to 10) minutes in the non-ICH group. The patient age, gender, potassium level, and time interval from intubation to ROSC were significant variables in the multivariable analysis. In a multivariable logistic regression model that included these variables, the area under the receiver operating characteristic curve was 0.838.
Conclusion:
OHCA patients with ICH achieve ROSC after intubation in a shorter amount of time than those without ICH.

Key words: Advanced cardiac life support, Cardiopulmonary resuscitation, Intracranial hemorrhages, Intubation, Prognosis