Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients

Background: Hybrid emergency department (ED), which are equipped with fluoroscopy and computed tomography has been developed in Japan as a novel emergency care room. Although hybrid ED is effective in improving the outcomes of severe trauma, its influence on the management of out-of-hospital cardiac...

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Main Authors: Takashi Nakata, Daisuke Kudo, Yasushi Kudo, Atsushi Tanikawa, Ken Katsuta, Hiroyuki Ohbe, Masakazu Kobayashi, Akira Suda, Satoshi Yasuda, Shigeki Kushimoto
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520424002157
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author Takashi Nakata
Daisuke Kudo
Yasushi Kudo
Atsushi Tanikawa
Ken Katsuta
Hiroyuki Ohbe
Masakazu Kobayashi
Akira Suda
Satoshi Yasuda
Shigeki Kushimoto
author_facet Takashi Nakata
Daisuke Kudo
Yasushi Kudo
Atsushi Tanikawa
Ken Katsuta
Hiroyuki Ohbe
Masakazu Kobayashi
Akira Suda
Satoshi Yasuda
Shigeki Kushimoto
author_sort Takashi Nakata
collection DOAJ
description Background: Hybrid emergency department (ED), which are equipped with fluoroscopy and computed tomography has been developed in Japan as a novel emergency care room. Although hybrid ED is effective in improving the outcomes of severe trauma, its influence on the management of out-of-hospital cardiac arrest (OHCA) requiring extracorporeal cardiopulmonary resuscitation (ECPR) remains unclear. Objectives: The aim of this study was to elucidate the impact of hybrid ED on ECPR procedures and outcome in OHCA patients focusing on time from hospital arrival to establishment of ECPR. Methods: A retrospective single-center cohort study was conducted, including adult OHCA patients who underwent ECPR between April 2013 and March 2022. Patients treated in conventional ED were compared with those in hybrid ED. Primary outcome was time from hospital arrival to ECPR initiation. Secondary outcomes included favorable neurological outcome at 30 days and incidence of cannulation-related adverse events. Results: Hybrid ED installation led to a significant decrease in time to ECPR initiation. In the interpreted time series analysis for the time from hospital arrival to establishment ECPR, there was statistically significant upward level change and downward trend change after the installation of hybrid ED. These results mean the time from hospital arrival to the establishment of ECPR was prolonged just after installation of hybrid ER, and the time from hospital arrival to the establishment of ECPR was shortened over time. There were no statistically significant differences between the conventional and hybrid ED groups on the favorable neurological outcome and cannulation-related adverse events. Conclusions: The installation of hybrid ED was associated with shortened time from hospital arrival to establishment of ECPR. Further evaluation is needed to elucidate the effects of hybrid ED on OHCA and determine an optimal strategy.
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spelling doaj-art-064d5ad8e42e424fa1402f2450894c502025-08-20T01:57:00ZengElsevierResuscitation Plus2666-52042024-12-012010076410.1016/j.resplu.2024.100764Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patientsTakashi Nakata0Daisuke Kudo1Yasushi Kudo2Atsushi Tanikawa3Ken Katsuta4Hiroyuki Ohbe5Masakazu Kobayashi6Akira Suda7Satoshi Yasuda8Shigeki Kushimoto9Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Corresponding author at: Tohoku University Graduate School of Medicine 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanBackground: Hybrid emergency department (ED), which are equipped with fluoroscopy and computed tomography has been developed in Japan as a novel emergency care room. Although hybrid ED is effective in improving the outcomes of severe trauma, its influence on the management of out-of-hospital cardiac arrest (OHCA) requiring extracorporeal cardiopulmonary resuscitation (ECPR) remains unclear. Objectives: The aim of this study was to elucidate the impact of hybrid ED on ECPR procedures and outcome in OHCA patients focusing on time from hospital arrival to establishment of ECPR. Methods: A retrospective single-center cohort study was conducted, including adult OHCA patients who underwent ECPR between April 2013 and March 2022. Patients treated in conventional ED were compared with those in hybrid ED. Primary outcome was time from hospital arrival to ECPR initiation. Secondary outcomes included favorable neurological outcome at 30 days and incidence of cannulation-related adverse events. Results: Hybrid ED installation led to a significant decrease in time to ECPR initiation. In the interpreted time series analysis for the time from hospital arrival to establishment ECPR, there was statistically significant upward level change and downward trend change after the installation of hybrid ED. These results mean the time from hospital arrival to the establishment of ECPR was prolonged just after installation of hybrid ER, and the time from hospital arrival to the establishment of ECPR was shortened over time. There were no statistically significant differences between the conventional and hybrid ED groups on the favorable neurological outcome and cannulation-related adverse events. Conclusions: The installation of hybrid ED was associated with shortened time from hospital arrival to establishment of ECPR. Further evaluation is needed to elucidate the effects of hybrid ED on OHCA and determine an optimal strategy.http://www.sciencedirect.com/science/article/pii/S2666520424002157Hybrid emergency departmentExtracorporeal cardiopulmonary resuscitationOut-of-hospital cardiac arrest
spellingShingle Takashi Nakata
Daisuke Kudo
Yasushi Kudo
Atsushi Tanikawa
Ken Katsuta
Hiroyuki Ohbe
Masakazu Kobayashi
Akira Suda
Satoshi Yasuda
Shigeki Kushimoto
Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
Resuscitation Plus
Hybrid emergency department
Extracorporeal cardiopulmonary resuscitation
Out-of-hospital cardiac arrest
title Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
title_full Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
title_fullStr Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
title_full_unstemmed Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
title_short Effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
title_sort effects of hybrid emergency department on extracorporeal cardiopulmonary resuscitation in out of hospital cardiac arrest patients
topic Hybrid emergency department
Extracorporeal cardiopulmonary resuscitation
Out-of-hospital cardiac arrest
url http://www.sciencedirect.com/science/article/pii/S2666520424002157
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