Aerosol generation during chest compression and defibrillation in a swine cardiac arrest model

Hsu, Cindy H.; Tiba, Mohamad H.; Boehman, André L.; McCracken, Brendan; Leander, Danielle C; Francalancia, Stephanie; Pickell, Zachary; Sanderson, Thomas H.; Ward, Kevin R.; Neumar, Robert W.

doi:10.1016/j.resuscitation.2020.12.004

Cited by 21 publications

(18 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Last, based on previous pandemic experience and recognizing CPR as an aerosol generating event, studies recommend safety for rescuers ( 17 , 18 ). These safety measure include use of personal protective equipment (PPE), minimizing healthcare professionals in the room, use of mechanical CPR where available, and the use of video laryngoscopy for intubation ( 10 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

Bhardwaj

Alwakeel

Saleem

et al. 2021

Critical Care Explorations

View full text Add to dashboard Cite

IMPORTANCE: In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12%. These numbers are significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20–25% in the United States for non–coronavirus disease 2019 patients. OBJECTIVE: To assess the incidence of in-hospital cardiac arrest survival of coronavirus disease 2019 patients. DESIGN: A retrospective cohort study of adult patients with coronavirus disease 2019 subsequently found to have in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (cardiopulmonary resuscitation). SETTING: Multiple hospitals of the Cleveland Clinic Health System. PATIENTS: All adult patients (age ≥ 18 yr) admitted to Cleveland Clinic Health System with a diagnosis of coronavirus disease 2019 who experienced in-hospital cardiac arrest requiring cardiopulmonary resuscitation. MEASUREMENTS AND MAIN RESULTS: From March 01, 2020 to October 15, 2020, 3,555 patients with coronavirus disease 2019 were hospitalized; 1,372 were admitted to the ICU; 58 patients had in-hospital cardiac arrest. Median age of this cohort was 66.5 years (interquartile range, 55.0–76.0 yr). Patients were predominantly male (62.5%), White (53.4%), with a median body mass index of 29.7 (interquartile range, 25.8–34.6). Most in-hospital cardiac arrests were in critical care environments (ICU), 51 of 58 (87.9%); seven of 58 (12.1%) were on ward locations. Thirty-four of 58 patients (58.6%) were on mechanical ventilation prior to in-hospital cardiac arrest with a median duration of mechanical ventilation of 9 days (interquartile range, 2–18 d). Twenty-four of 58 patients (44%) were on vasopressors prior to arrest. Initial arrest rhythm was pulseless electrical activity at (63.8%), asystole (29.3%), and pulseless ventricular tachycardia/fibrillation (6.9%). Of the 58 patients, 35 (60.3%) attained return of spontaneous circulation, and 13 of 58 (22.4%) were discharged alive. CONCLUSIONS: We report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar to before the coronavirus disease 2019 pandemic.

show abstract

Section: Discussionmentioning

confidence: 99%

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

Bhardwaj

Alwakeel

Saleem

et al. 2021

Critical Care Explorations

View full text Add to dashboard Cite

show abstract

“…Moreover, it could also be attributed to certain recommendations that CPR is not an aerosol-generating procedure 41 – 43 , thus, decreasing the likelihood for COVID-19 to be transmitted. A recent study with swine models validates such findings, where the authors found that chest compressions alone did not cause significant aerosol generation in the swine model 44 . However, our findings should be interpreted with caution as an analysis on BCPR rates for home versus non-home arrests could not be performed due to paucity of data.…”

Section: Discussionmentioning

confidence: 61%

Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis

Teoh

Yeo

Tan

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Bystander cardiopulmonary resuscitation (BCPR), early defibrillation and timely treatment by emergency medical services (EMS) can double the chance of survival from out-of-hospital sudden cardiac arrest (OHCA). We investigated the effect of the COVID-19 pandemic on the pre-hospital chain of survival. We searched five bibliographical databases for articles that compared prehospital OHCA care processes during and before the COVID-19 pandemic. Random effects meta-analyses were conducted, and meta-regression with mixed-effect models and subgroup analyses were conducted where appropriate. The search yielded 966 articles; 20 articles were included in our analysis. OHCA at home was more common during the pandemic (OR 1.38, 95% CI 1.11–1.71, p = 0.0069). BCPR did not differ during and before the COVID-19 pandemic (OR 0.94, 95% CI 0.80–1.11, p = 0.4631), although bystander defibrillation was significantly lower during the COVID-19 pandemic (OR 0.65, 95% CI 0.48–0.88, p = 0.0107). EMS call-to-arrival time was significantly higher during the COVID-19 pandemic (SMD 0.27, 95% CI 0.13–0.40, p = 0.0006). Resuscitation duration did not differ significantly between pandemic and pre-pandemic timeframes. The COVID-19 pandemic significantly affected prehospital processes for OHCA. These findings may inform future interventions, particularly to consider interventions to increase BCPR and improve the pre-hospital chain of survival.

show abstract

“…A recent study with swine models validates such ndings, where the authors found that chest compressions alone did not cause signi cant aerosol generation in the swine model. [43] However, our ndings should be interpreted with caution as an analysis on BCPR rates for home versus non-home arrests could not be performed due to paucity of data. Furthermore, this result should be interpreted in light of signi cant statistical heterogeneity unexplained by the sociodemographic, economic status, and geographical location of the sample population in each study.…”

Section: Discussionmentioning

confidence: 81%

Variation in Community and Ambulance Care Processes for Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Teoh

Yeo

Tan

et al. 2021

Preprint

View full text Add to dashboard Cite

Bystander cardiopulmonary resuscitation (BCPR) and early defibrillation can double the chance of survival from out-of-hospital sudden cardiac arrest (OHCA). We investigated the effect of COVID-19 on the pre-hospital chain of survival. We searched five bibliographical databases for articles that compared prehospital OHCA care processes during and before the COVID-19 pandemic. Random effects meta-analyses were conducted, and meta-regression with mixed-effect models and subgroup analyses were conducted where appropriate. The search yielded 966 articles; 20 articles were included in our analysis. OHCA at home was more common during the pandemic (OR=1.38, 95%CI 1.11-1.71, p=0.0069). BCPR did not differ between COVID-19 and Pre-COVID-19 populations (OR=0.94, 95%CI 0.80-1.11, p=0.4631), although bystander defibrillation was significantly lower during the COVID-19 period (OR=0.65, 95%CI 0.48-0.88, p=0.0107). EMS call-to-arrival time was significantly higher in COVID-19 populations (SMD=0.27, 95%CI 0.13-0.40, p=0.0006). Resuscitation duration did not differ significantly between pandemic and pre-pandemic timeframes. The COVID-19 pandemic significantly affected prehospital processes for OHCA. These findings may inform future interventions, particularly to consider interventions to increase BCPR and improve the pre-hospital chain of survival.

show abstract

Aerosol generation during chest compression and defibrillation in a swine cardiac arrest model

Cited by 21 publications

References 16 publications

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis

Variation in Community and Ambulance Care Processes for Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About