Current post-resuscitation management of out-of-hospital cardiac arrest patients admitted to intensive cardiovascular care units

• DOI: 10.1093/ehjacc/zuae036.068
• Publication Date: 2024-05-09T00:07:09Z
• Authors: R Andrea Riba; P Loma-Osorio; E Sanz-Girgas; C Garcia-Garcia; T Soriano; A Sionis; I Llao; P Pastor; M Izquierdo-Ribas; E Moreno; C Roca-Guerrero; T Lopez-Sobrino; J T Ortiz-Perez; X Freixa; O De Diego
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main source(s): Consell Català de Resucitació 2022. Background Out-of-hospital cardiac arrest (OHCA) accounts the 50% cardiovascular deaths. Neuroprognostication must be done in a multimodal approach as recommended by ILCOR guidelines but its application real life is challenging. Aim To investigate current post-resuscitation care and neurological prognostication OHCA patients admitted to mediterranean Intensive Cardiac Care Unit (ICCU) during 2020s. Methods PCR-Cat was prospective observational multicenter registry. ICCU 8 catalan hospitals were included from October/2020 December/2021. Post-OHCA management analyzed including neuroprognostication tools targeted temperature (TTM) approach. Patients classified into 2 groups according main outcome at 6-month follow-up: good (CPC 1-2, GO) or poor (death CPC 3-4, PO). Results 288 included, mean age 61.45 ± 13.76 only 17.36% female. GO follow-up occurred 48.95% patients. Total medium time until ROSC 28 min first rhythm shockable 80%. An emergent coronary angiography 68.9% any moment hospitalization 83.5% (PCI 56.5%). There no association between presence type significant artery disease outcome. TTM applied 65.33% target 33ºC 71.76%, 34ºC 3.53%, 35ºC 2.35% 36ºC 22.35%, with statistically differences PO groups. The neuronal specific enolase (NSE) determined 57 % 24 hours, 45% 48h 57% 72 h. Myoclonus more frequent (51.20% vs. 7.52%, p<0.001). Almost one electroencephalogram performed 60.4% patients, somato-sensorial evoked potentials 53.01%, cerebral computed tomography 57.75% magnetic resonance imaging 19.38%. As expected, an abnormal result all those tests, when performed, related (Table 1). In-hospital mortality 46%. cause death 72.90%. percentage 1-2 increased throughout period (Figure Conclusions Although clearly indicate use for neuroprognostication, real-life setting, conventional tests evaluation are used differently every center, depending on their expertise facility resources.Figure 1