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

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; I(2) = 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.