Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis

Akihito Hagihara, Manabu Hasegawa, Takeru Abe, Yoshifumi Wakata, Takashi Nagata, Yoshihiro Nabeshima

研究成果: ジャーナルへの寄稿記事

12 引用 (Scopus)

抄録

Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event. Methods and Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan. We performed a propensity analysis and examined the association between prehospital use of LR solution and short- and long-term survival. The study patients were ≥18 years of age, had an OHCA before arrival of EMS personnel, were treated by EMS personnel, and were then transported to hospitals. A total of 531,854 patients with OHCA met the inclusion criteria. Among propensity-matched patients, compared with those who did not receive pre-hospital intravenous fluids, prehospital use of LR solution was associated with an increased likelihood of ROSC before hospital arrival (odds ratio [OR] adjusted for all covariates [95% CI] = 1.239 [1.146-1.339] [p<0.001], but with a reduced likelihood of 1-month survival with minimal neurological or physical impairment (cerebral performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.764 [0.589-0.992] [p = 0.04]; and overall performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.746 [0.573-0.971] [p = 0.03]). There was no association between prehospital use of LR solution and 1-month survival (OR adjusted for all covariates [95% CI] = 0.960 [0.854-1.078]). Conclusion: In Japanese patients experiencing OHCA, the prehospital use of LR solution was independently associated with a decreased likelihood of a good functional outcome 1 month after the event, but with an increased likelihood of ROSC before hospital arrival. Prehospital use of LR solution was not associated with 1-month survival. Further study is necessary to verify these findings. Please see later in the article for the Editors' Summary.

元の言語英語
記事番号e1001394
ジャーナルPLoS Medicine
10
発行部数2
DOI
出版物ステータス出版済み - 3 6 2013

Fingerprint

Out-of-Hospital Cardiac Arrest
Cohort Studies
Survival
Odds Ratio
Therapeutics
Ringer's solution
Ringer's lactate
Observational Studies
Japan

All Science Journal Classification (ASJC) codes

  • Medicine(all)

これを引用

Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest : A Prospective Cohort Analysis. / Hagihara, Akihito; Hasegawa, Manabu; Abe, Takeru; Wakata, Yoshifumi; Nagata, Takashi; Nabeshima, Yoshihiro.

:: PLoS Medicine, 巻 10, 番号 2, e1001394, 06.03.2013.

研究成果: ジャーナルへの寄稿記事

Hagihara, Akihito ; Hasegawa, Manabu ; Abe, Takeru ; Wakata, Yoshifumi ; Nagata, Takashi ; Nabeshima, Yoshihiro. / Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest : A Prospective Cohort Analysis. :: PLoS Medicine. 2013 ; 巻 10, 番号 2.
@article{9c76c58381b84683a656b6f158668896,
title = "Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis",
abstract = "Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event. Methods and Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan. We performed a propensity analysis and examined the association between prehospital use of LR solution and short- and long-term survival. The study patients were ≥18 years of age, had an OHCA before arrival of EMS personnel, were treated by EMS personnel, and were then transported to hospitals. A total of 531,854 patients with OHCA met the inclusion criteria. Among propensity-matched patients, compared with those who did not receive pre-hospital intravenous fluids, prehospital use of LR solution was associated with an increased likelihood of ROSC before hospital arrival (odds ratio [OR] adjusted for all covariates [95{\%} CI] = 1.239 [1.146-1.339] [p<0.001], but with a reduced likelihood of 1-month survival with minimal neurological or physical impairment (cerebral performance category 1 or 2, OR adjusted for all covariates [95{\%} CI] = 0.764 [0.589-0.992] [p = 0.04]; and overall performance category 1 or 2, OR adjusted for all covariates [95{\%} CI] = 0.746 [0.573-0.971] [p = 0.03]). There was no association between prehospital use of LR solution and 1-month survival (OR adjusted for all covariates [95{\%} CI] = 0.960 [0.854-1.078]). Conclusion: In Japanese patients experiencing OHCA, the prehospital use of LR solution was independently associated with a decreased likelihood of a good functional outcome 1 month after the event, but with an increased likelihood of ROSC before hospital arrival. Prehospital use of LR solution was not associated with 1-month survival. Further study is necessary to verify these findings. Please see later in the article for the Editors' Summary.",
author = "Akihito Hagihara and Manabu Hasegawa and Takeru Abe and Yoshifumi Wakata and Takashi Nagata and Yoshihiro Nabeshima",
year = "2013",
month = "3",
day = "6",
doi = "10.1371/journal.pmed.1001394",
language = "English",
volume = "10",
journal = "PLoS Medicine",
issn = "1549-1277",
publisher = "Public Library of Science",
number = "2",

}

TY - JOUR

T1 - Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest

T2 - A Prospective Cohort Analysis

AU - Hagihara, Akihito

AU - Hasegawa, Manabu

AU - Abe, Takeru

AU - Wakata, Yoshifumi

AU - Nagata, Takashi

AU - Nabeshima, Yoshihiro

PY - 2013/3/6

Y1 - 2013/3/6

N2 - Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event. Methods and Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan. We performed a propensity analysis and examined the association between prehospital use of LR solution and short- and long-term survival. The study patients were ≥18 years of age, had an OHCA before arrival of EMS personnel, were treated by EMS personnel, and were then transported to hospitals. A total of 531,854 patients with OHCA met the inclusion criteria. Among propensity-matched patients, compared with those who did not receive pre-hospital intravenous fluids, prehospital use of LR solution was associated with an increased likelihood of ROSC before hospital arrival (odds ratio [OR] adjusted for all covariates [95% CI] = 1.239 [1.146-1.339] [p<0.001], but with a reduced likelihood of 1-month survival with minimal neurological or physical impairment (cerebral performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.764 [0.589-0.992] [p = 0.04]; and overall performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.746 [0.573-0.971] [p = 0.03]). There was no association between prehospital use of LR solution and 1-month survival (OR adjusted for all covariates [95% CI] = 0.960 [0.854-1.078]). Conclusion: In Japanese patients experiencing OHCA, the prehospital use of LR solution was independently associated with a decreased likelihood of a good functional outcome 1 month after the event, but with an increased likelihood of ROSC before hospital arrival. Prehospital use of LR solution was not associated with 1-month survival. Further study is necessary to verify these findings. Please see later in the article for the Editors' Summary.

AB - Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event. Methods and Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan. We performed a propensity analysis and examined the association between prehospital use of LR solution and short- and long-term survival. The study patients were ≥18 years of age, had an OHCA before arrival of EMS personnel, were treated by EMS personnel, and were then transported to hospitals. A total of 531,854 patients with OHCA met the inclusion criteria. Among propensity-matched patients, compared with those who did not receive pre-hospital intravenous fluids, prehospital use of LR solution was associated with an increased likelihood of ROSC before hospital arrival (odds ratio [OR] adjusted for all covariates [95% CI] = 1.239 [1.146-1.339] [p<0.001], but with a reduced likelihood of 1-month survival with minimal neurological or physical impairment (cerebral performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.764 [0.589-0.992] [p = 0.04]; and overall performance category 1 or 2, OR adjusted for all covariates [95% CI] = 0.746 [0.573-0.971] [p = 0.03]). There was no association between prehospital use of LR solution and 1-month survival (OR adjusted for all covariates [95% CI] = 0.960 [0.854-1.078]). Conclusion: In Japanese patients experiencing OHCA, the prehospital use of LR solution was independently associated with a decreased likelihood of a good functional outcome 1 month after the event, but with an increased likelihood of ROSC before hospital arrival. Prehospital use of LR solution was not associated with 1-month survival. Further study is necessary to verify these findings. Please see later in the article for the Editors' Summary.

UR - http://www.scopus.com/inward/record.url?scp=84874452493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874452493&partnerID=8YFLogxK

U2 - 10.1371/journal.pmed.1001394

DO - 10.1371/journal.pmed.1001394

M3 - Article

C2 - 23431275

AN - SCOPUS:84874452493

VL - 10

JO - PLoS Medicine

JF - PLoS Medicine

SN - 1549-1277

IS - 2

M1 - e1001394

ER -