Resuscitation - Time Interval from Intubation to Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest Patient with Brain Hemorrhage

Sep 23, 2026

This retrospective observational study investigates how the time interval from intubation to return of spontaneous circulation (ROSC) relates to the presence of intracranial hemorrhage (ICH) in out-of-hospital cardiac arrest (OHCA) patients. Data were drawn from a prospectively collected OHCA registry (January 2008 to December 2016). Non-traumatic adults undergoing brain computed tomography were analyzed, excluding prehospital ROSC or advanced airway management. Compared with non-ICH patients, the ICH group achieved ROSC significantly faster; age, sex, potassium, and intubation-to-ROSC time were significant, yielding an AUC of 0.838. The findings suggest shorter ROSC latency after intubation in OHCA patients with ICH.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Purpose

Methods

Results

Conclusion

Introduction

Background on OHCA and ICH

Article Summary

What is already known

What is new in the current study

Materials and Methods

대한응급의학회지 제 29 권 제 1 호 􀓭 원 저 􀓭 Volume 29, Number 1, February, 2018 Resuscitation Time Interval from Intubation to Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest Patient with Brain Hemorrhage Sumin Baek, M.D.1, Euigi Jung, M.D.1*, Jonghwan Shin, M.D.1, Hui Jai Lee, M.D.1, Se Jong Lee, M.D.1, Kyoung Min You, M.D.1, Kyuseok Kim, M.D.2, You Hwan Jo, M.D.2, Jae Hyuk Lee, M.D.2, Joonghee Kim, M.D.2 Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul1 , Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam2 , Korea Purpose: This study was conducted to investigate the relationship of time interval from intubation to return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients according to the presence or absence of intracranial hemorrhage (ICH) . Methods: This retrospective study used data from a prospectively collected OHCA registry for patients treated from January 2008 to December 2016. Non-traumatic adult OHCA patients who underwent brain computed tomography were included, while patients who achieved a prehospital ROSC or required advanced airway management were excluded. Utstein variables, initial blood gas analysis, electrolyte levels, and the time interval from intubation to ROSC were used to compare the ICH and non-ICH groups. Results: A total of 448 patients were analyzed. The ICH group was younger and had more females than the non-ICH group. The time interval from intubation to ROSC was significantly shorter in the ICH group than the non-ICH group. The median time and interquartile range were 3 (2 to 7) minutes in the ICH group and 6 (3 to 10) minutes in the non-ICH group. The patient age, gender, potassium level, and time interval from intubation to ROSC were significant variables in the multivariable analysis. In a multivariable logistic regression model that included these variables, the area under the receiver operating characteristic curve was 0.838. Conclusion: OHCA patients with ICH achieve ROSC after intubation in a shorter amount of time than those without ICH. Key Words: Advanced cardiac life support, Cardiopulmonary resuscitation, Intracranial hemorrhages, Intubation, Prognosis Introduction Although the main causes of out-of-hospital cardiac arrest (OHCA) are of cardiac origin, cardiac arrest of non-cardiac origin accounts for approximately one-third of cases 1) . The incidence of intracranial hemorrhage (ICH) diagnosis among the cases of non-cardiac arrest has been increasing due to the increasing use of brain computed tomography (CT) after a return of spontaneous circulation (ROSC) . The prevalence of ICH, mainly subarachnoid hemorrhage (SAH), in OHCA patients with ROSC after cardiopulmonary resuscitation (CPR) and brain CT has been reported to be 2% to 4% in the United States and Europe and 6% to 18% in East Asia2-8) . It is usually difficult to distinguish between cardiac causes and ICH-related causes during prehospital or hospital CPR and immediately after resuscitation due to the sudden occurrence of cardiac arrest and large number of STsegment changes on an electrocardiogram after ROSC in 책임저자: 정 의 기 서울특별시 동작구 보라매로 5길 20 서울대학교 의과대학 보라매병원 응급의학과 Tel: 02-870-2667, Fax: 02-831-0714, E-mail: [nicedoctor00@gmail.com](nicedoctor00@gmail.com) 접수일: 2017년 10월 12일, 1차 교정일: 2017년 10월 12일, 게재승인일: 2017년 11월 19일 􀓈 The authors would like to thank all of the emergency department research assistants in both hospitals for their contributions to the study. Article Summary What is already known in the previous study Theories concerning cardiac arrest after the development of intracranial hemorrhage (ICH) include a sudden increase in intracranial pressure, a mass effect from hematoma, intraventricular hemorrhage with acute expansion of the fourth ventricle, pulmonary edema, and cardiac dysrhythmia, all of which can result in early death from subarachnoid hemorrhage10

FAQs

What is the purpose of this study?

To investigate the relationship between the time interval from intubation to ROSC and the presence or absence of intracranial hemorrhage in OHCA patients.

What patient data and inclusion criteria were used?

The study used a prospectively collected OHCA registry for January 2008 to December 2016, including non-traumatic adult OHCA patients who underwent brain computed tomography and excluding those with prehospital ROSC or who required advanced airway management.

What key result was found regarding ICH and ROSC timing?

The time interval from intubation to ROSC was significantly shorter in the ICH group than in the non-ICH group, with a median of 3 minutes vs 6 minutes.

Sep 23, 2026

Uploaded by PakDamar76