The time interval between endotracheal intubation success and return of spontaneous circulation in OHCA patient with intracranial hemorrhage

Abstract

Objective: The incidence of out-of-hospital cardiac arrest (OHCA) patients due to intracranial hemorrhage (ICH) is relatively higher in East Asia than in the United States or Europe. Although several theories have been suggested, the mechanism of arrest due to ICH is unclear. Empirically, there is a tendency of shorter time interval between endotracheal intubation success (ETS) and return of spontaneous circulation (ROSC) in arrests due to ICH compared to other causes. Therefore, we compared the time interval between ETS and ROSC in ICH group and non-ICH group.

Methods: A retrospective observational study based on a prospective OHCA registry was conducted in an emergency department (ED) at two university hospitals from January 2009 to January 2014. Patient variables, according to Utstein-style, about OHCA and time interval during ACLS at ED were analyzed. Data are presented as medians with 25th and 75th percentiles.

Result: In total, 370 subjects were included in this study; 53 and 317 patients were in the ICH and non-ICH groups, respectively. Among the Utstein variables, there were statistically significant between-group differences for gender and age. The time interval from ED arrival to ETS was 3 (2–5) min in the ICH group and 3 (2–4) min in the non-ICH group (p = 0.247). However, the time interval from ETS to ROSC was 4 (1–8) min in the ICH group and 6 (2–12) minutes in the non-ICH group (p = 0.036).

Conclusion: There was a significantly shorter time interval from ETS to ROSC in the ICH group than in the non-ICH group.