Cardiopulmonary resuscitation: Analysis of six years' experience and review of the literature

DeBard, Mark L.

doi:10.1016/s0196-0644(81)80307-1

Cited by 151 publications

(38 citation statements)

References 44 publications

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“…[14][15][16] Furthermore, long-term survival beyond hospital discharge after CPR remains largely unclear, with studies reporting conflicting results. 6,[16][17][18][19] We, therefore, investigated outcomes after in-hospital CPR in older adults with chronic illness by using 14 years of Medicare hospital data.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Stapleton

Ehlenbach

Deyo

et al. 2014

Chest

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Section: Discussionmentioning

confidence: 99%

Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Stapleton

Ehlenbach

Deyo

et al. 2014

Chest

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“…However, only six studies were identified in a review of the literature that reported results for more than 500 patients, and only one included more than 1,000 patients. 10,36,41,43,47,56 Therefore, the majority of studies have had inadequate sample size to identify important predictors of the outcome of in-hospital CPR. Although smaller studies have shown relations between pre-arrest variables and the outcome of CPR, those associations have been inconsistent.…”

Section: Jgimmentioning

confidence: 99%

“…Studies not meeting minimal inclusion criteria as described above were removed from the spreadsheet and excluded from further analysis. Studies were excluded for the following reasons: included patients with a pulse, 10 included children, 34,46 included out-of-hospital arrests, 36,46 or duplicated data from another analysis by the same authors. 48,56 One study was excluded because only a single patient met the inclusion criteria.…”

Section: Data Abstractionmentioning

confidence: 99%

Survival after in-hospital cardiopulmonary resuscitation

et al. 1998

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OBJECTIVE:To determine the rates of immediate survival and survival to discharge for adult patients undergoing in-hospital cardiopulmonary resuscitation, and to identify demographic and clinical variables associated with these outcomes. MEASUREMENTS AND MAIN RESULTS:The MEDLARS database of the National Library of Medicine was searched. In addition, the authors' extensive personal files and the bibliography of each identified study were searched for further studies. Two sets of inclusion criteria were used, minimal (any study of adults undergoing in-hospital cardiopulmonary resuscitation) and strict (included only patients from general ward and intensive care units, and adequately defined cardiopulmonary arrest and resuscitation). Each study was independently reviewed and abstracted in a nonblinded fashion by two reviewers. The data abstracted were compared, and any discrepancies were resolved by consensus discussion. For the subset of studies meeting the strict criteria, the overall rate of immediate survival was 40.7% and the rate of survival to discharge was 13.4%. The following variables were associated with failure to survive to discharge: sepsis on the day prior to resuscitation (odds ratio T he do-not-resuscitate (DNR) order has become well accepted and widely used in American hospitals, and for the majority of patients who die in the hospital, a DNR order has been written by the time of their death. 1-3 The decision to discuss or execute a DNR order is driven by several concerns: the patient's current quality of life, the likelihood that cardiopulmonary resuscitation (CPR) will be successful, the patient's long-term prognosis following successful resuscitation, and his or her anticipated quality of life following successful resuscitation. 4,5 Although judgments about quality of life are best assessed by the patient, physicians have typically been relied on to provide biomedical information and estimates of prognosis; this is consistent with a shared approach to medical decision making. Information about prognosis can either be communicated implicitly (e.g., "I don't think CPR is likely to help you") or explicitly ("Patients with your condition have a less than 1% chance of surviving to discharge after CPR"). The explicit approach has been shown in two studies to influence patient decisions about DNR orders, 6,7 so it is important that prognostic information be as accurate as possible.[Recent work has shown, however, that physicians are not accurate in predicting the outcome of CPR. In fact, when presented with detailed vignettes of actual patient cases, physician predictions of the likelihood of immediate survival following CPR were no better than random guessing, with an area under the receiver-operating characteristic (ROC) curve not significantly different from 0.5. 8 An analysis with the physician prediction of the likelihood of survival as the outcome variable in a multivariate regression shows that physicians appear to have an underlying cognitive model. However, this model overemphasizes the imp...

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“…Modem methods of cardiopulmonary resuscitation and advanced cardiac life support can successfully restore spontaneous circulation in up to 56% of victims of prehospital cardiac arrest (DeBard, 1981). However, fewer than half of the initially resuscitated patients survive to leave the hospital (DeBard, 1981;Eisenberg et al, 1979;Myerburg et al, 1980).…”

Section: Introductionmentioning

confidence: 99%

“…However, fewer than half of the initially resuscitated patients survive to leave the hospital (DeBard, 1981;Eisenberg et al, 1979;Myerburg et al, 1980). Central nervous system (CNS) damage and hemodynamic abnormalities have caused 59% and 31%, respectively, of postresuscitation, in-hospital deaths (Myerburg et al, 1980), and permanent functional neurologic disability is reported in 10%-40% of patients surviving prehospital cardiac arrest (Liberthson et al, 1974).…”

Section: Introductionmentioning

confidence: 99%

The effect of carbon dioxide, lidoflazine and deferoxamine upon long term survival following cardiorespiratory arrest in rats

Badylak

Babbs

1986

Resuscitation

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SUMMARYThis study examined the effect of carbon dioxide, lidoflazine, and deferoxamine therapy upon the 10-day survival incidence and subsequent neurologic function of rats subjected to 7 min of cardiorespiratory arrest with resuscitation. Cardiac arrest (asystole) was induced at time zero by injection of cold, 1% KCl into the left ventricle of ketamine-anesthetized rats pretreated with succinylcholine. Positive pressure ventilation was discontinued at time zero. Cardiopulmonary resuscitation (CPR) was begun at 7 min, and animals with return of spontaneous circulation were entered into the study. Twenty treated rats were ventilated for 1 h with 7% carbon dioxide-93% oxygen and given lidoflazine (2.0 mg/kg, i.v.) and deferoxamine (50 mg/kg, i.v.) 5 min after CPR. Twenty control rats were ventilated for 1 h with 100% oxygen and given lidoflazine vehicle and deferoxamine vehicle. Lidoflazine treatment (1.0 mg/ kg) for the treated group, or lidoflazine vehicle for the control group, was repeated at 8 h postresuscitation. At 2 days postresuscitation, 75% of treated rats vs. 25% of control rats were alive (Chi-square = 10.0, d.f. = 1, P < 0.01), and at 10 days, 60% of treated rats vs. 25% of control rats were alive (Chi-square = 5.01, d.f. = 1, P < 0.05). There was no detectable neurologic deficit among survivors in either group at 15 days. The combination of carbon dioxide, lidoflazine, and deferoxamine, administered after return of spontaneous circulation, is a simple and easily administered treatment regimen that improves the survival incidence without neurologic deficits in this animal model of cardiorespiratory arrest and CPR.

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Cardiopulmonary resuscitation: Analysis of six years' experience and review of the literature

Cited by 151 publications

References 44 publications

Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Long-term Outcomes After In-Hospital CPR in Older Adults With Chronic Illness

Survival after in-hospital cardiopulmonary resuscitation

The effect of carbon dioxide, lidoflazine and deferoxamine upon long term survival following cardiorespiratory arrest in rats

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