Neurologically Intact Survival after Prolonged Cardiopulmonary Resuscitation for Pulseless Ventricular Tachycardia

Ibrahim, Akram W.; Wu, Victor; Zafari, A. Maziar

doi:10.1016/j.amjmed.2012.11.008

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…The Invos 5100 C near infrared spectroscopy device (Invos Somanetics, Troy, USA) was utilized. A disposable sensor was applied to the patient's forehead . Light emitted from the diodes is used to calculate the frontal cortical hemoglobin concentration; resulting values represent cerebral arteriovenous saturation (normal range 60% to 80%) …”

Section: Methodssupporting

confidence: 81%

“…A disposable sensor was applied to the patient's forehead. 14 Light emitted from the diodes is used to calculate the frontal cortical hemoglobin concentration; resulting values represent cerebral arteriovenous saturation (normal range 60% to 80%). 15 The near infrared spectroscopy device did not interfere with CPR efforts or post-arrest interventions and was not used by medical staff to alter management.…”

Section: Study Interventionmentioning

confidence: 99%

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Cerebral Oximetry as a Real‐Time Monitoring Tool to Assess Quality of In‐Hospital Cardiopulmonary Resuscitation and Post Cardiac Arrest Care

Ibrahim

Trammell

Austin

et al. 2015

JAHA

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BackgroundRegional cerebral oxygen saturation (rSO2) as assessed by near infrared frontal cerebral spectroscopy decreases in circulatory arrest and increases with high-quality cardiopulmonary resuscitation. We hypothesized that higher rSO2 during cardiopulmonary resuscitation and after return of spontaneous circulation (ROSC) would predict survival to discharge and neurological recovery.Methods and ResultsThis prospective case series included patients experiencing in-hospital cardiac arrest. Cerebral oximetry was recorded continuously from initiation of resuscitation until ROSC and up to 48 hours post-arrest. Relationships between oximetry data during these time periods and outcomes of resuscitation survival and survival to discharge were analyzed. The cohort included 27 patients. Nineteen (70.3%) achieved ROSC, and 8 (29.6%) survived to discharge. Median arrest duration was 20.8 minutes (range =8 to 74). There was a significant difference in rSO2 between resuscitation survivors and resuscitation nonsurvivors at initiation of the resuscitative efforts (35% versus 17.5%, P =0.03) and during resuscitation (36% versus 15%, P =0.0008). No significant association was observed between rSO2 at ROSC or during the post-arrest period and survival to discharge. Among patients who survived to discharge, there was no association between cerebral performance category and rSO2 at ROSC, during resuscitation, or post-arrest.ConclusionsHigher rSO2 levels at initiation of resuscitation and during resuscitation are associated with resuscitation survival and may reflect high-quality cardiopulmonary resuscitation. However, in this small series, rSO2 was not predictive of good neurological outcome. Larger studies are needed to determine whether this monitoring modality can be used to improve clinical outcomes.

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Section: Methodssupporting

confidence: 81%

Section: Study Interventionmentioning

confidence: 99%

Cerebral Oximetry as a Real‐Time Monitoring Tool to Assess Quality of In‐Hospital Cardiopulmonary Resuscitation and Post Cardiac Arrest Care

Ibrahim

Trammell

Austin

et al. 2015

JAHA

Self Cite

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A Case of Neurologically Intact Survival after 2 hours and 50 minutes of Euthermic Cardiac Arrest Treated with Mechanical CPR and Intra-arrest Percutaneous Coronary Intervention

Burnett¹,

Frascone²,

Brechtken³

et al. 2018

Prehospital Emergency Care

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We report a case of a 56 year old male in ventricular fibrillation (VF) cardiac arrest for a total of 2 hours and 50 minutes who was diagnosed with ST elevation myocardial infarction (STEMI) during a brief 10 min period of return of spontaneous circulation (ROSC). The patient underwent successful percutaneous coronary intervention (PCI) while receiving mechanical chest compressions for ongoing VF. Our case demonstrates the potential for neurologically intact survival in VF cardiac arrest patients despite prolonged periods of VF who are treated with mechanical CPR and intra-arrest PCI.

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Review and Outcome of Prolonged Cardiopulmonary Resuscitation

Youness

Halabi

Hussein

et al. 2016

Critical Care Research and Practice

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The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts.

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Neurologically Intact Survival after Prolonged Cardiopulmonary Resuscitation for Pulseless Ventricular Tachycardia

Cited by 3 publications

References 11 publications

Cerebral Oximetry as a Real‐Time Monitoring Tool to Assess Quality of In‐Hospital Cardiopulmonary Resuscitation and Post Cardiac Arrest Care

Cerebral Oximetry as a Real‐Time Monitoring Tool to Assess Quality of In‐Hospital Cardiopulmonary Resuscitation and Post Cardiac Arrest Care

A Case of Neurologically Intact Survival after 2 hours and 50 minutes of Euthermic Cardiac Arrest Treated with Mechanical CPR and Intra-arrest Percutaneous Coronary Intervention

Review and Outcome of Prolonged Cardiopulmonary Resuscitation

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