ID | 66529 |
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Naito, Hiromichi
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Hanafusa, Hiroaki
Emergency and Critical Care Center, Tsuyama Chuo Hospital
Hongo, Takashi
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Yumoto, Tetsuya
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Yorifuji, Takashi
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Weissman, Alexandra
Department of Emergency Medicine, University of Pittsburgh School of Medicine
Rittenberger, Jon C.
Department of Emergency Medicine, Guthrie Robert Packer Hospital
Guyette, Francis X.
Department of Emergency Medicine, University of Pittsburgh School of Medicine
Fujishima, Mamoru
Department of Radiology, Tsuyama Chuo Hospital
Maeyama, Hiroki
Emergency and Critical Care Center, Tsuyama Chuo Hospital
Nakao, Astunori
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Abstract | Background: Gastric inflation caused by excessive ventilation is a common complication of cardiopulmonary resuscitation. Gastric inflation may further compromise ventilation via increases in intrathoracic pressure, leading to decreased venous return and cardiac output, which may impair out-of-hospital cardiac arrest (OHCA) outcomes. The purpose of this study was to measure the gastric volume of OHCA patients using computed tomography (CT) scan images and evaluate the effect of gastric inflation on return of spontaneous circulation (ROSC).
Methods: In this single-center, retrospective, observational study, CT scan was conducted after ROSC or immediately after death. Total gastric volume was measured. Primary outcome was ROSC. Achievement of ROSC was compared in the gastric distention group and the no gastric distention group; gastric distension was defined as total gastric volume in the ≥75th percentile. Additionally, factors associated with gastric distention were examined. Results: A total of 446 cases were enrolled in the study; 120 cases (27%) achieved ROSC. The median gastric volume was 400 ml for all OHCA subjects; 1068 ml in gastric distention group vs. 287 ml in no gastric distention group. There was no difference in ROSC between the groups (27/112 [24.1%] vs. 93/334 [27.8%], p = 0.440). Gastric distention did not have a significant impact, even after adjustments (adjusted odds ratio 0.73, 95% confidence interval [0.42–1.29]). Increased gastric volume was associated with longer emergency medical service activity time. Conclusions: We observed a median gastric volume of 400 ml in patients after OHCA resuscitation. In our setting, gastric distention did not prevent ROSC. |
Keywords | Heart arrest
Cardiopulmonary resuscitation
Airway management
Ventilation
Insufflation
Regurgitation
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Published Date | 2023-12
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Publication Title |
Resuscitation
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Volume | volume193
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Publisher | Elsevier BV
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Start Page | 109994
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ISSN | 0300-9572
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NCID | AA00817253
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2023 The Author(s).
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File Version | publisher
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Related Url | isVersionOf https://doi.org/10.1016/j.resuscitation.2023.109994
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License | http://creativecommons.org/licenses/by-nc-nd/4.0/
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Funder Name |
Nippon Kyukyu Iryo Zaidan
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