Analysis of Prehospital Care for Cardiac Arrest in an Urban Setting in Japan

Yanagawa, Youichi; Sakamoto, Toshihisa

doi:10.1016/j.jemermed.2008.04.037

Cited by 30 publications

(26 citation statements)

References 31 publications

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“…Yet, the populations were dissimilar, and despite multi-variable regression analysis, there were many confounding variables. A similar before-after study was conducted in Singapore by Ong et al,[30] as epinephrine was incorporated into management of OHCA in October 2003. [29] This study did not find any significant differences between the epinephrine treated population and those not treated with epinephrine with respect to survival to hospital discharge (or survival at 30 days post-arrest if still in hospital), and rates of ROSC.…”

Section: Resultsmentioning

confidence: 98%

“…Another group of observational studies,[18,29,30] using a before-after approach, reflects modifications in resuscitation guidelines to allow EMS personnel to administer epinephrine in OHCA. Two of the included studies[18,30] were based on a protocol change in Japan, where emergency life-saving technicians were permitted to establish an intravenous line and administer epinephrine according to Japanese Fire and Disaster Management Agency resuscitation guidelines since 2006.…”

Section: Resultsmentioning

confidence: 99%

“…Two of the included studies[18,30] were based on a protocol change in Japan, where emergency life-saving technicians were permitted to establish an intravenous line and administer epinephrine according to Japanese Fire and Disaster Management Agency resuscitation guidelines since 2006. Before this period, epinephrine was administered only when patients were attended by a physician-manned ambulance.…”

Section: Resultsmentioning

confidence: 99%

“…Owing to attempts made by the authors to match populations and reduce bias and confounders, the study was given a high quality rating by the review team with its conclusions limited solely by its observational methodology. Yanagawa and colleagues[30] also used before-after data from the modified Japanese guidelines. They conducted a retrospective study to examine factors associated with pre-hospital ROSC and good recovery (CPC 1 and 2).…”

Section: Resultsmentioning

confidence: 99%

“…[16,17,23,27] However, the clinical significance of this outcome is uncertain with a number of studies reporting either no improvement or a decrease in survival to hospital discharge or a decrease in favourable neurological outcome. [18,19,26,30]…”

Section: Discussionmentioning

confidence: 99%

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Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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BACKGROUND:Epinephrine is recommended in advanced cardiac life support guidelines for use in adult cardiac arrest, and has been used in cardiopulmonary resuscitation since 1896. Yet, despite its long time use and incorporation into guidelines, epinephrine suffers from a paucity of evidence regarding its influence on survival. This critical review was conducted to address the knowledge deficit regarding epinephrine in out-of-hospital cardiac arrest and its effect on return of spontaneous circulation, survival to hospital discharge, and neurological performance.METHODS:The EMBASE and MEDLINE (through the Pubmed interface) databases, and the Cochrane library were searched with the key words “epinephrine”, “cardiac arrest” and variations of these terms. Original research studies concerning epinephrine use in adult, out-of-hospital cardiac arrest were selected for further review.RESULTS:The search yielded nine eligible studies based on inclusion criteria. This includes five prospective cohort studies, one retrospective cohort study, one survival analysis, one case control study, and one RCT. The evidence clearly establishes an association between epinephrine and increased return of spontaneous circulation, the data were conflicting concerning survival to hospital discharge and neurological outcome.CONCLUSIONS:The results of this review exhibit the paucity of evidence regarding the use of epinephrine in out of hospital cardiac arrest. There is currently insufficient evidence to support or reject its administration during resuscitation. Larger sample, placebo controlled, double blind, randomized control trials need to be performed to definitively establish the effect of epinephrine on both survival to hospital discharge and the neurological outcomes of treated patients.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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Hypoxic cardiopulmonary arrest with full recovery after induced hypothermic therapy

Matsuo

Yanagawa

Takeuchi

et al. 2013

Acute Medicine & Surgery

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A review of ventilation in adult out‐of‐hospital cardiac arrest

et al. 2020

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Out‐of‐hospital cardiac arrest continues to be a devastating condition despite advances in resuscitation care. Ensuring effective gas exchange must be weighed against the negative impact hyperventilation can have on cardiac physiology and survival. The goals of this narrative review are to evaluate the available evidence regarding the role of ventilation in out‐of‐hospital cardiac arrest resuscitation and to provide recommendations for future directions. Ensuring successful airway patency is fundamental for effective ventilation. The airway management approach should be based on professional skill level and the situation faced by rescuers. Evidence has explored the influence of different ventilation rates, tidal volumes, and strategies during out‐of‐hospital cardiac arrest; however, other modifiable factors affecting out‐of‐hospital cardiac arrest ventilation have limited supporting data. Researchers have begun to explore the impact of ventilation in adult out‐of‐hospital cardiac arrest outcomes, further stressing its importance in cardiac arrest resuscitation management. Capnography and thoracic impedance signals are used to measure ventilation rate, although these strategies have limitations. Existing technology fails to reliably measure real‐time clinical ventilation data, thereby limiting the ability to investigate optimal ventilation management. An essential step in advancing cardiac arrest care will be to develop techniques to accurately and reliably measure ventilation parameters. These devices should allow for immediate feedback for out‐of‐hospital practitioners, in a similar way to chest compression feedback. Once developed, new strategies can be established to guide out‐of‐hospital personnel on optimal ventilation practices.

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Analysis of Prehospital Care for Cardiac Arrest in an Urban Setting in Japan

Cited by 30 publications

References 31 publications

Epinephrine in out-of-hospital cardiac arrest:A critical review

Epinephrine in out-of-hospital cardiac arrest:A critical review

Hypoxic cardiopulmonary arrest with full recovery after induced hypothermic therapy

A review of ventilation in adult out‐of‐hospital cardiac arrest

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