UNASSIGNED: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital @entity1167 . Hypothesis The likelihood of favorable neurological outcome declines with increasing PPI. METHODS: This investigation was a retrospective study of @entity1167 using linked data from the Cardiac Arrest Registry to Enhance Survival (CARES) database (Centers for Disease Control and Prevention [Atlanta, Georgia USA]; American Heart Association [Dallas, Texas USA]; and Emory University Department of Emergency Medicine [Atlanta, Georgia USA]) and the North Carolina (USA) Prehospital Medical Information System. Adult @entity1 suffering a bystander-witnessed, non-traumatic @entity1167 between January 2012 and June 2014 were included. Logistic regression was used to calculate the adjusted odds ratio (OR) of neurological outcome as a function of PPI, while controlling for @entity1 age, gender, and race; endotracheal intubation (ETI); shockable rhythm; layperson cardiopulmonary resuscitation (CPR); and field @entity2332 . RESULTS: Of the 2,100 @entity1 meeting inclusion criteria, 913 (43.5%) experienced ROSC, 618 (29.4%) survived to hospital admission, 187 (8.9%) survived to hospital discharge, and 155 (7.4%) were discharged with favorable neurological outcomes (CPC 1 or 2). Favorable neurological outcome was less likely with increasing PPI (OR=0.90; P<.01) and increasing age (OR=0.97; P<.01). Compared to @entity1 with non-shockable rhythms, @entity1 with shockable rhythms were more likely to have favorable neurological outcomes (OR=7.61; P<.01) as were @entity1 receiving field @entity2332 (OR=2.13; P<.01). @entity1 gender, non-Caucasian race, layperson CPR, and ETI were not independent predictors of favorable neurological outcome. CONCLUSION: In this evaluation, time to vasopressor administration was significantly associated with favorable neurological outcome. Among adult, witnessed, non-traumatic arrests, the odds of hospital discharge with CPC 1 or 2 declined by 10% for every one-minute delay between PSAP call-receipt and vasopressor administration. These retrospective observations support the notion of a time-dependent function of vasopressor effectiveness on favorable neurological outcome. Large, prospective studies are needed to verify this relationship. Hubble MW , Tyson C . Impact of early vasopressor administration on neurological outcomes after prolonged out-of-hospital @entity1167 . Prehosp Disaster Med. 2017; 32(3):1-8.

Impact of Early Vasopressor Administration on Neurological Outcomes after XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['hypothermia'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest']
@entity1167 :: (MESH:D006323,Disease) :: ['Prolonged Out-of-Hospital Cardiac Arrest']
