Prehospital Lactated Ringer's Solution Treatment and Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis

Akihito Hagihara, Manabu Hasegawa, Takeru Abe, Yoshifumi Wakata, Takashi Nagata and Yoshihiro Nabeshima

PLOS Medicine, 2013, vol. 10, issue 2, 1-12

Abstract: In a cohort of more than 500,000 individuals who experienced out-of-hospital cardiac arrest in Japan, Akihito Hagihara and colleagues studied whether administration of lactated Ringer's solution was associated with survival and functional outcomes. Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event. Methods and Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan. We performed a propensity analysis and examined the association between prehospital use of LR solution and short- and long-term survival. The study patients were ≥18 years of age, had an OHCA before arrival of EMS personnel, were treated by EMS personnel, and were then transported to hospitals. A total of 531,854 patients with OHCA met the inclusion criteria. Among propensity-matched patients, compared with those who did not receive pre-hospital intravenous fluids, prehospital use of LR solution was associated with an increased likelihood of ROSC before hospital arrival (odds ratio [OR] adjusted for all covariates [95% CI] = 1.239 [1.146–1.339] [p

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1001394

DOI: 10.1371/journal.pmed.1001394

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