Background
Despite advances in cardiopulmonary resuscitation, functional survival remains low
after out-of-hospital cardiac arrest (OOHCA). Intra-aortic balloon pump (IABP) therapy
has recently been shown to augment cerebral blood flow. Whether IABP therapy in the
post-resuscitation period improves functional outcomes is unknown.
Methods
We analysed 174 consecutive patients who were successfully resuscitated from an OOHCA
between 2011-2013 at Harefield Hospital, London. We analysed functional status at
discharge and mortality up to one year.
Results
A total of 55 patients (32.1%) received IABP therapy. Comparing those receiving IABP
with those not receiving IABP, there was no difference in favourable functional status
at discharge (49.1% vs. 57.1%, p=0.321); and mortality at one year (45.5% vs. 35.5%,
p=0.164). Multivariable analyses identified IABP therapy as a strong independent predictor
for favourable functional status at discharge (OR=7.51, 95% CI: 2.15-26.14, p=0.002)
and this association was maintained in propensity-score adjusted analyses (OR=9.90,
95% CI: 2.11-46.33, p=0.004) and inverse probability treatment weighted analyses (OR=10.84,
95% CI: 2.75-42.69, p<0.001). However, IABP therapy was not an independent predictor
for mortality at one year (HR=0.93, 95% CI: 0.52-1.65, p=0.810) and this was confirmed
in both propensity-score adjusted and inverse probability treatment weighted analyses.
Conclusions
In this observational analysis of patients surviving an OOHCA, the use of IABP therapy
in the post-resuscitation period was associated with improved functional outcomes.
This warrants further evaluation in larger prospective studies.
Keywords
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Article info
Publication history
Published online: May 20, 2016
Accepted:
April 1,
2016
Received in revised form:
March 20,
2016
Received:
January 11,
2016
Identification
Copyright
© 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
