Dobutamine Use in Patients With Extracorporeal Cardiopulmonary Resuscitation Following Out-of-Hospital Cardiac...

The effects of dobutamine on outcomes in patients experiencing out-of-hospital cardiac arrest (OHCA), treated with extracorporeal cardiopulmonary resuscitation (ECPR), remain unclear. In this study, we aimed to evaluate the association between dobutamine use within 24 h and clinical outcomes in patients with OHCA who underwent ECPR.

A post hoc analysis was conducted on the registry data from the SAVE-J II study (2013-2018). To address potential confounding variables related to dobutamine administration, 1:3 propensity score matching was employed using the patients' baseline characteristics. Following the matching, the dobutamine and non-dobutamine groups were compared, focusing on in-hospital mortality and neurological outcomes assessed using the cerebral performance category (CPC) scale.

Of the 2157 registered cases, 581 cases of cardiogenic OHCA treated with targeted temperature management were included in this analysis. Eighty-eight patients who received dobutamine were compared with 264 who did not after propensity score matching. The in-hospital mortality rate was 60.2% in the dobutamine group, compared with 58.3% in the non-dobutamine group (p = 0.80). The proportion of patients with a CPC score of 3-5 at hospital discharge was 79.5% in the dobutamine group, compared with 78.0% in the non-dobutamine group (p = 0.88). A Kaplan-Meier analysis demonstrated no significant differences in survival rates between the two groups (42.1 vs. 43.6%, log-rank p = 0.79).

In patients with OHCA who underwent ECPR, dobutamine administration within 24 h was not significantly associated with in-hospital mortality and neurological outcomes.