Changes in pre‐ and in‐hospital management and outcomes for out‐of‐hospital cardiac arrest between 2002 and 2012 in Kanto, Japan: the SOS‐KANTO 2012 Study

Abstract

Methods: We compared the data collected for the SOS-KANTO study project in 2002 and 2012. We included adult patients (aged >18 years) who experienced bystander-witnessed out-of-hospital cardiac arrest of cardiac etiology. The outcomes were as follows: proportion of favorable neurological outcomes at 1 month, bystander cardiopulmonary resuscitation provision, and pre-and postresuscitation treatment administration. Conclusions: Proportions of bystander cardiopulmonary resuscitation, layperson use of automated external defibrillator, provision of prehospital adrenaline and postresuscitation treatment, and favorable neurological outcomes at 1 month increased significantly over 10 years in the Kanto region of Japan. Results:

Confirmed cardiac output on emergency medical services arrival as confounding by indication: an observational study of prehospital airway management in patients with out-of-hospital cardiac arrest

“…In the Japanese EMS system, the ambulance crew consists of three EMS members, including at least one emergency lifesaving technician (ELST) 13 14. ELSTs can perform several resuscitative techniques with online medical supervision, including the operation of a semi-automated external defibrillator, insertion of supraglottic airway devices (laryngeal mask airway, laryngeal tube and oesophageal-tracheal twin lumen airway device) and intubation and intravenous administration of epinephrine.…”

“…We conducted a registry study with follow-up of adult (≥18) victims of OHCA in the Kanto region (SOS-KANTO) in 2012 13. This study was planned and conducted to gather prehospital and inhospital records of patients with CA who were transported to one of the 67 emergency hospitals in the Kanto region of Japan between January 2012 and March 2013.…”

Antiarrhythmic drugs for out-of-hospital cardiac arrest with refractory ventricular fibrillation

“…This finding was also reported in a retrospective study by Harayama et al [23], who found that nifekalant achieved faster ROSC after refractory VF/pVT than did amiodarone. More recently, Amino et al [25] evaluated the results of a large multicenter prospective study (SOS‐KANTO 2012 [26]). These investigators retrospectively investigated nifekalant potency and differential effects of two initial amiodarone doses (150 or 300 mg) as compared with lidocaine doses in the Japanese population.…”

Amplitude-Integrated Electroencephalography and Brain Oxygenation for Postcardiac Arrest Patients with Targeted Temperature Management

“…Despite recent medical advances, the outcome of patients resuscitated from cardiac arrest is still very poor. In Japan, 87% of patients experiencing cardiac arrest outside of the hospital died and even in cases of witnessed arrest and with cardiac etiology, only 9% achieved a good neurological outcome (SOS-KANTO 2012 Study Group, 2015). The International Liaison Committee on Resuscitation defined causes of postcardiac arrest syndrome (PCAS) into four types of pathophysiology: postcardiac arrest brain injury, postcardiac arrest myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathology (Nolan et al , 2008).…”