Cardiopulmonary Resuscitation in the Hospitalized Patient: Impact of System-Based Variables on Outcomes in Cardiac Arrest

Kantamineni, Phani; Emani, Vamsi; Saini, Ankur; Rai, Hardeep; Duggal, Abhijit

doi:10.1097/maj.0000000000000290

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…Consistent with findings from other studies,[1724252637383940] witnessed arrests and shorter time of CPR were associated with higher survival rates when compared to unwitnessed arrests or a longer duration of resuscitation. The administration of adrenaline boluses during the resuscitation was associated with a higher survival rate than continuous infusion.…”

Section: Discussionsupporting

confidence: 91%

“…[17242526] A third factor that might result in higher survival rates is the level of training of the resuscitation team members and their adherence to resuscitation guidelines. Many previously published studies reported better survival rates after formal resuscitation training,[2728293031] while Curry and Gass[32] found that the death rate was not lower when resuscitation was performed by BLS-trained staff in comparison to untrained staff.…”

Section: Discussionmentioning

confidence: 99%

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An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

et al. 2017

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Objectives:Data reflecting cardiopulmonary resuscitation (CPR) efforts in Saudi Arabia are limited. In this study, we analyzed the characteristics, and estimated the outcome, of in-hospital CPR in a teaching hospital in Saudi Arabia over 4 years.Methods:A retrospective, observational study was conducted between January 2009 and December 2012 and included 4361 patients with sudden cardiopulmonary arrest. Resuscitation forms were reviewed. Demographic data, resuscitation characteristics, and survival outcomes were recorded.Results:The mean ± standard deviation age of arrested patient was 40 ± 31 years. The immediate survival rate was 64%, 43% at 24 h, and 30% at discharge. The death rate was 70%. Respiratory type of arrest, time and place of arrest, short duration of arrest, witnessed arrest, the use of epinephrine and atropine boluses, and shockable arrhythmias were associated with higher 24-h survival rates. A low survival rate was found among patients with cardiac types of arrest, and those with a longer duration of arrest, pulseless electrical activity, and asystole. Comorbidities were present in 3786 patients with cardiac arrest and contributed to a poor survival rate (P < 0.001).Conclusions:The study confirms the findings of previously published studies in highly developed countries and provides some reflection on the practice of resuscitation in Saudi Arabia.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

et al. 2017

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“…The duration of cardiopulmonary resuscitation (CPR) is also associated with CA outcomes. [15] Here, the duration of CPR in intubationrelated CA group tended to be shorter than in the intubation-unrelated CA group, but this difference was not statistically significant (5.0 vs 8.0 minutes; p=0.22). Despite the short duration of CPR, the rate of discharge with good neurological outcome was poor (14.3%).…”

Section: Discussioncontrasting

confidence: 49%

Prevalence and outcomes of endotracheal intubation–related cardiac arrest in the ED

Ahn

Ryoo

et al. 2015

The American Journal of Emergency Medicine

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“…Duration of cardiopulmonary resuscitation, age, initial rhythm, and witnessed events are factors that have been described to influence survival of any kind of sudden cardiac arrest; ie, in-hospital cardiac arrest6 as well as out-of-hospital cardiac arrest 7. However, as patients of in-hospital cardiac arrest are hospitalized due to preexisting illness, they cannot be directly compared with patients of out-of-hospital cardiac arrests; for example, acute apoplectic stroke, preexisting severe sepsis, and preexisting poor CPC scores have been associated with a very poor prognosis for surviving in-hospital cardiac arrest in a good neurological state 8…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

Christ¹,

Dierschke²,

Auenmueller³

et al. 2014

IJGM

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ObjectivesLittle is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates.Material and methodsIn-hospital cardiac arrest teams at our hospital were instructed to complete a questionnaire following every emergency call between July 2011 and June 2013. Data on all resuscitation attempts were collected and analyzed.ResultsA total of 65 in-hospital resuscitations were recorded in 42 males (64.6%) and 23 females (35.4%) (mean age 72.0±14.3 years). A total of 54 (83.1%) cardiac arrests were witnessed; seven (10.8%) showed a shockable rhythm at the time of the first ECG. Resuscitation attempts lasted 29.3±41.3 minutes, and 4.1±3.1 mg epinephrine was given. Return of spontaneous circulation could be achieved in 38 patients (58.5%); 29 (44.6%) survived the first day, 23 (35.4%) the seventh day, and 15 patients (23.1%) were discharged alive. Significantly more in-hospital resuscitations were obtained for those performed during non-regular working hours (P<0.001), with higher neuron-specific enolase levels at 72 hours after resuscitation during nonregular working hours (P=0.04). Patients who were discharged alive were significantly younger (P=0.01), presented more often with an initial shockable rhythm (P=0.04), and had a shorter duration of resuscitation (P<0.001) with the need of a lower dose of epinephrine (P<0.001).DiscussionSurvival rates following in-hospital resuscitation were poor at any time, but appear to depend less on time-dependent effects of the quality of resuscitation and more on time-dependent effects of recognition of cardiac arrests.

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Cardiopulmonary Resuscitation in the Hospitalized Patient: Impact of System-Based Variables on Outcomes in Cardiac Arrest

Cited by 14 publications

References 28 publications

An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

Prevalence and outcomes of endotracheal intubation–related cardiac arrest in the ED

Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

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