The presence of gasping predicts long-term survival in out-of-hospital cardiac arrest patients

Abstract

Background. The presence of gasping in out-of-hospital cardiac arrest (OHCA) patients predicts short-term prognosis. We performed a retrospective study to evaluate whether the presence of gasping at the time of Emergency Medical Service (EMS) arrival in the case OHCA patients of presumed cardian origin has any impact on six-month survival and/ or sustained return of spontaneous circulation (ROSC). Methods. We collected and analyzed Utstein Style data for all patients resuscitated for OHCA of presumed cardiac origin by the EMS of the Central Bohemian Region from Results. During the data collection period, 565 cases of OHCA of presumed cardiac origin were reported. Gasping at the time of EMS arrival was identified in 23.9%. The presence of gasping was associated with a significantly increased frequency of sustained ROSC (48.1 versus 20.7%, P<0.001) and six-month survival (40.7 versus 16.7%, P<0.001) than in non-breathing patients. Presence of gasping upon EMS arrival has been found to be an independent positive predictor of sustained ROSC (OR 2.51, CI 95% 1. 59-3.98, P<0.001). The occurrence of gasping at the time of EMS arrival at the scene was significantly related to response time from EMS activation to arrival. Conclusion. The presence of gasping upon arrival of the EMS for the patient with OHCA of presumed cardiac origin predicts both improves short-term and long-term prognoses.

Prognostic value of gasping for short and long outcomes during out-of-hospital cardiac arrest: an updated systematic review and meta-analysis

“…The remaining 26 full-text articles were assessed for eligibility, and 21 were excluded for various reasons (i.e., animal studies or different study content or populations). Finally, 5 studies [7, 11–14] were included in the meta-analysis. The selection process is shown in Fig.…”

“…Martens et al reported two databases [12]. All five studies (six cohorts) reported the result of ROSC, two studies [13, 14] reported favorable neurological outcome at discharge or at 30 days after CA, two studies [11, 14] reported long term survival, four studies [7, 11, 13, 14] reported initial shockable rhythm.…”

“…Gasping is an abnormal breathing pattern which has been defined as an abrupt, sudden and transient inspiratory effort [11]. It is further characterized by short inspiration and expiration and a longer and variable expiratory pause [5].…”

“…In the present study, we observed moderate or high heterogeneity for the short and long outcome results, which may be due to the different methods for determining the presence of gasping during CA in these 5 studies.Martens et al [12] and Knor et al [11] retrospectively reviewed CPR registries, which leaves their data prone to lacking or incorrect entries. Moreover, the study by Martens et al [12] included cases from more than 30 years ago.…”

Agonal breathing upon hospital arrival as a prognostic factor in patients experiencing out-of-hospital cardiac arrest

“… 6 A systematic review investigated whether agonal breathing predicts short-term and long-term outcomes in OHCA. 7 The review, which included five studies, showed that agonal breathing was associated with a significant increase in the rate of return of spontaneous circulation (risk ratio [RR], 1.87; 95% CI, 1.64–2.13) and with a higher likelihood of favorable neurological outcomes (RR, 3.79; 95% CI, 1.86–7.73) and increased long-term survival (≥6 months) (RR, 3.46; 95% CI, 1.70–7.07) 6 , 16 , 17 , 18 . Debaty G. 2017 et al, reported that the combination of agonal breathing and appropriate initial shock waveform for electrical shock application had higher for favorable patient outcomes compared to no agonal breathing and no shockable rhythm.…”