The association of emergency department administration of sodium bicarbonate after out of hospital cardiac arrest with outcomes - 15/10/18

Doi : 10.1016/j.ajem.2018.03.010

Yi-Chuan Chen ^a,^b, Ming-Szu Hung ^c,^d , Chia-Yen Liu ^e, Cheng-Ting Hsiao ^a,^d,^{^⁎,}^{^{1
Cheng-Ting Hsiao and Yao-Hsu Yang have the same contributions to the manuscript and thus are both co-corresponding authors.}} , Yao-Hsu Yang ^e,^f,^g,^{^⁎⁎,}^{^{1
Cheng-Ting Hsiao and Yao-Hsu Yang have the same contributions to the manuscript and thus are both co-corresponding authors.}}
^a Department of Emergency Medicine, Chang Gung Memorial Hospital, No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan
^b Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
^c Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan
^d Chang Gung University College of Medicine, No.5, Fusing St., Gueishan Township, Taoyuan County 333, Taiwan
^e Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan
^f Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
^g School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

^⁎Correspondence to: C.-T.Hsiao, Department of Emergency Medicine, Chang Gung Memorial Hospital, No.6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan.Department of Emergency MedicineChang Gung Memorial HospitalNo.6, W. Sec., Jiapu Rd.Puzih CityChiayi County613Taiwan^⁎⁎Correspondence to: Y.-H. Yang, Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.Department for Traditional Chinese MedicineChang Gung Memorial HospitalChia-YiTaiwan

Abstract

Background

Sodium bicarbonate administration is mostly restricted to in-hospital use in Taiwan. This study was conducted to investigate the effect of sodium bicarbonate on outcomes among patients with out-of-hospital cardiac arrest (OHCA).

Methods

This population-based study used a 16-year database to analyze the association between sodium bicarbonate administration for resuscitation in the emergency department (ED) and outcomes. All adult patients with OHCA were identified through diagnostic and procedure codes. The primary outcome was survival to hospital admission and secondary outcome was the rate of death within the first 30days of incidence of cardiac arrest. Cox proportional-hazards regression, logistic regression, and propensity analyses were conducted.

Results

Among 5589 total OHCA patients, 15.1% (844) had survival to hospital admission. For all patients, a positive association was noted between sodium bicarbonate administration during resuscitation in the ED and survival to hospital admission (adjusted odds ratio [OR]: 4.47; 95% confidence interval [CI]: 3.82–5.22, p<0.001). In propensity-matched patients, a positive association was also noted (adjusted OR, 4.61; 95% CI: 3.90–5.46, p<0.001).

Conclusions

Among patients with OHCA in Taiwan, administration of sodium bicarbonate during ED resuscitation was significantly associated with an increased rate of survival to hospital admission.

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Keywords : OHCA, Out-of-hospital cardiac arrest, Sodium bicarbonate, Cardiac arrest

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☆	All authors read and approved the final manuscript.

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Vol 36 - N° 11

P. 1998-2004 - novembre 2018 Retour au numéro

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The association of emergency department administration of sodium bicarbonate after out of hospital cardiac arrest with outcomes - 15/10/18

Abstract

Background

Methods

Results

Conclusions

Plan

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