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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2018

Open Access 01-12-2018 | Review

Prognostic value of gasping for short and long outcomes during out-of-hospital cardiac arrest: an updated systematic review and meta-analysis

Authors: Qiang Zhang, Bo Liu, Zhijiang Qi, Chunsheng Li

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2018

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Abstract

Objective

We systematically reviewed the literature to investigate whether gasping could predict short and long outcomes in patients with out of hospital cardiac arrest (OHCA).

Methods

PubMed, Embase, and Cochrane Library were searched for observational studies regarding the prognostic effect of gasping on short and long outcomes in adults with OHCA. The primary outcome was return of spontaneous circulation (ROSC). The secondary outcomes were favorable neurological outcome at discharge or at 30 days after cardiac arrest;long term (≥6 months) survival; initial shockable rhythm.The Mantel-Haenszel method with random-effects model was used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs).

Results

Five studies (six cohorts) were included in the final analysis. In the pooled analysis, gasping was not only associated with a significant increase in ROSC (RR, 1.87; 95% CI, 1.64–2.13; I2 = 70%), but also a high likelihood of favorable neurological outcomes (RR, 3.79; 95% CI, 1.86–7.73), long-term survival (RR, 3.46; 95% CI, 1.70–7.07), and initial shockable rhythm (RR, 2.25; 95% CI, 2.05–2.48).

Conclusions

Current evidence indicates that gasping can predict short and long outcomes in patients with OHCA.In addition, gasping is associated with a high likelihood of initial shockable rhythm,which may contribute to positive outcomes.
Literature
1.
Tamhane UU, Chetcuti S, Hameed I, et al. Safety and efficacy of thrombectomy in patients undergoing primary percutaneous coronary intervention for acute ST elevation MI: a meta-analysis of randomized controlled trials [J]. BMC Cardiovasc Disord. 2010;10:10.CrossRef
2.
Haouzi P, Ahmadpour N, Bell HJ, et al. Breathing patterns during cardiac arrest [J]. J Appl Physiol (1985). 2010;109(2):405–11.CrossRef
3.
Soar J, Nolan JP, Bottiger BW, et al. European resuscitation council guidelines for resuscitation 2015: section 3. Adult advanced life support [J]. Resuscitation. 2015;95:100–47.CrossRef
4.
Bobrow BJ, Zuercher M, Ewy GA, et al. Gasping during cardiac arrest in humans is frequent and associated with improved survival [J]. Circulation. 2008;118(24):2550–4.CrossRef
5.
Zuercher M, Ewy GA. Gasping during cardiac arrest [J]. Curr Opin Crit Care. 2009;15(3):185–8.CrossRef
6.
Zhao L, Li C, Liu B, et al. The association of gasping and outcome, in out of hospital cardiac arrest: a systematic review and meta-analysis [J]. Resuscitation. 2015;97:7–12.CrossRef
7.
Wolfskeil M, Vanwulpen M, Duchatelet C, et al. Detection and quantification of gasping during resuscitation for out-of-hospital cardiac arrest [J]. Resuscitation. 2017;117:40–5.CrossRef
8.
Cook DA, Reed DA. Appraising the quality of medical education research methods: the medical education research study quality instrument and the Newcastle-Ottawa scale-education [J]. Acad Med. 2015;90(8):1067–76.CrossRef
9.
Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses [J]. BMJ. 2003;327(7414):557–60.CrossRef
10.
Egger M, Davey SG, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test [J]. BMJ. 1997;315(7109):629–34.CrossRef
11.
Knor J, Seblova J, Skulec R, et al. The presence of gasping predicts long-term survival in out-of-hospital cardiac arrest patients [J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018;162(1):32–5.CrossRef
12.
Martens P, Mullie A, Vanhaute O. Clinical status before and during cardiopulmonary resuscitation versus outcome in two consecutive databases. Belgian CPCR study group [J]. Eur J Emerg Med. 1995;2(1):17–23.CrossRef
13.
Fukushima H, Panczyk M, Hu C, et al. Description of Abnormal Breathing Is Associated With Improved Outcomes and Delayed Telephone Cardiopulmonary Resuscitation Instructions [J]. J Am Heart Assoc. 2017;6(9).
14.
Debaty G, Labarere J, Frascone RJ, et al. Long-term prognostic value of gasping during out-of-hospital cardiac arrest [J]. J Am Coll Cardiol. 2017;70(12):1467–76.CrossRef
15.
Ewy GA, Armstrong PW. A natural biomarker deserving attention: gasping following primary cardiac arrest [J]. J Am Coll Cardiol. 2017;70(12):1477–8.CrossRef
16.
Zuercher M, Ewy GA, Otto CW, et al. Gasping in response to basic resuscitation efforts: observation in a Swine model of cardiac arrest. Crit Care Res Pract. 2010:2010.
17.
Zive DM, Schmicker R, Daya M, et al. Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium [J]. Resuscitation. 2018;131:74–82.CrossRef
18.
Clark JJ, Larsen MP, Culley LL, et al. Incidence of agonal respirations in sudden cardiac arrest [J]. Ann Emerg Med. 1992;21(12):1464–7.CrossRef
19.
Fukushima H, Imanishi M, Iwami T, et al. Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service dispatcher-assisted cardiopulmonary resuscitation instruction [J]. Emerg Med J. 2015;32(4):314–7.CrossRef
20.
Srinivasan V, Nadkarni VM, Yannopoulos D, et al. Spontaneous gasping decreases intracranial pressure and improves cerebral perfusion in a pig model of ventricular fibrillation [J]. Resuscitation. 2006;69(2):329–34.CrossRef
21.
Noc M, Weil MH, Tang W, et al. Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation [J]. Chest. 1995;108(3):821–7.CrossRef
22.
Noc M, Weil MH, Sun S, et al. Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation [J]. Am J Respir Crit Care Med. 1994;150(3):861–4.CrossRef
23.
Xie J, Weil MH, Sun S, et al. Spontaneous gasping generates cardiac output during cardiac arrest [J]. Crit Care Med. 2004;32(1):238–40.CrossRef
24.
Zuercher M, Ewy GA, Hilwig RW, et al. Continued breathing followed by gasping or apnea in a swine model of ventricular fibrillation cardiac arrest [J]. BMC Cardiovasc Disord. 2010;10:36.CrossRef
25.
Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest [J]. JAMA. 2013;310(13):1377–84.CrossRef
26.
Hardeland C, Sunde K, Ramsdal H, et al. Factors impacting upon timely and adequate allocation of prehospital medical assistance and resources to cardiac arrest patients [J]. Resuscitation. 2016;109:56–63.CrossRef
27.
Riou M, Ball S, Williams TA, et al. She's sort of breathing': what linguistic factors determine call-taker recognition of agonal breathing in emergency calls for cardiac arrest? [J]. Resuscitation. 2018;122:92–8.CrossRef
Metadata
Title
Prognostic value of gasping for short and long outcomes during out-of-hospital cardiac arrest: an updated systematic review and meta-analysis
Authors
Qiang Zhang
Bo Liu
Zhijiang Qi
Chunsheng Li
Publication date
01-12-2018
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-018-0575-1

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