The hospitalised out-of-hospital cardiac arrest patient: We need more research

Hassager, Christian; Møller, Jacob Eifer; Kjærgaard, Jesper

doi:10.1177/2048872620970068

Cited by 1 publication

(1 citation statement)

References 26 publications

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“…The majority of evidence arises from observational studies [46]. Hence, conclusions are susceptible to known biases, and limited to associating improved outcomes with CACs instead of establishing a causal link [47].…”

Section: What Are Cardiac Arrest Centres?mentioning

confidence: 99%

Cardiac arrest centres: what, who, when, and where?

Yeo

Ong

2022

Current Opinion in Critical Care

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Purpose of reviewCardiac arrest centres (CACs) may play a key role in providing postresuscitation care, thereby improving outcomes in out-of-hospital cardiac arrest (OHCA). There is no consensus on CAC definitions or the optimal CAC transport strategy despite advances in research. This review provides an updated overview of CACs, highlighting evidence gaps and future research directions.Recent findingsCAC definitions vary worldwide but often feature 24/7 percutaneous coronary intervention capability, targeted temperature management, neuroprognostication, intensive care, education, and research within a centralized, high-volume hospital. Significant evidence exists for benefits of CACs related to regionalization. A recent meta-analysis demonstrated clearly improved survival with favourable neurological outcome and survival among patients transported to CACs with conclusions robust to sensitivity analyses. However, scarce data exists regarding ‘who’, ‘when’, and ‘where’ for CAC transport strategies. Evidence for OHCA patients without ST elevation postresuscitation to be transported to CACs remains unclear. Preliminary evidence demonstrated greater benefit from CACs among patients with shockable rhythms. Randomized controlled trials should evaluate specific strategies, such as bypassing nearest hospitals and interhospital transfer.SummaryReal-world study designs evaluating CAC transport strategies are needed. OHCA patients with underlying culprit lesions, such as those with ST-elevation myocardial infarction (STEMI) or initial shockable rhythms, will likely benefit the most from CACs.

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Section: What Are Cardiac Arrest Centres?mentioning

confidence: 99%