Predictors and outcome of cardiopulmonary resuscitation (CPR) calls in a large haemodialysis unit over a seven-year period

Lafrance, Jean‐Philippe; Nolin, Linda; Senécal, Lynne; Leblanc, Martine

doi:10.1093/ndt/gfk007

Cited by 80 publications

(54 citation statements)

References 17 publications

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“…However, it has been documented that survival after cardiac arrest in the dialysis room is significantly lower in comparison to the other areas of the hospital; this finding does not come as a surprise considering the illness of the patients nursed there. 20 The data in this audit confirmed the better outcome during day shifts in comparison to those in night shifts, weekends and holidays. 21 …”

Section: Discussionsupporting

confidence: 69%

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Chakravarthy

Mitra

Nonis

2012

Indian Heart Journal

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Objective: Cardiac arrest in the hospital wards may not receive as much attention as it does in the operation theatre and intensive care unit (ICU). The experience and the qualifications of personnel in the ward may not be comparable to those in the other vital areas of the hospital. The outcome of cardiac arrest from the ward areas is a reasonable surrogate of training of the ward nurses and technicians in cardiopulmonary resuscitation. We conducted an audit to assess the issues surrounding the resuscitation of cardiac arrest in areas other than operation theatre and ICU in a tertiary referral hospital. Aims of the audit:To assess the outcomes of cardiac arrest in a tertiary referral hospital. Areas such as wards, dialysis room and emergency room were considered for the audit.Methods: This is a retrospective observational audit of the case records of all the adult patients who were resuscitated from 'code blue'. Data for 2 years from 2007 was analysed by a research fellow unconnected with the resuscitations.Results: Twenty-two thousand three hundred and forty-four patients were admitted as in-patients to the hospital during the 2 years, starting May 2007 through May 2009. One hundred code blue calls were received during this time. Twenty-two of the total calls received were false. Among the 78 confirmed cardiac arrests 69 occurred in the wards, 2 in emergency room, 1 in cardiac catheterisation laboratory and 3 in dialysis room. Twenty-eight patients were declared dead after unsuccessful cardiopulmonary resuscitation. Among the 50 who were resuscitated with a return of spontaneous rhythm 26 died. Twenty-four patients were discharged (survival rate of 30%). The survival decreased significantly as the age progressed beyond 60. The resuscitation rates were better in day shifts in contrast to the night. Higher survival was noted in patients who received resuscitation in less than a minute. Conclusion:A overall survival to discharge rate of 30% was noted in this audit. Higher survival rates might be attributable to high rate and degree of training at the time of their employment, which was repeated at yearly interval.

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Section: Discussionsupporting

confidence: 69%

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Chakravarthy

Mitra

Nonis

2012

Indian Heart Journal

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“…Unfortunately, dialysis patients typically have poor knowledge of their chances of survival after CPR (21,22). Despite the fact that CPR rarely extends survival for dialysis patients (23)(24)(25)(26), over a third of these patients would want to be resuscitated. Many of these patients regret their decision of dialysis over conservative care.…”

Section: Discussionmentioning

confidence: 99%

End-of-Life Care Preferences and Needs

Davison¹

2010

Clinical Journal of the American Society of Nephrology

560

549

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Background and objectives: Despite high mortality rates, surprisingly little research has been done to study chronic kidney disease (CKD) patients' preferences for end-of-life care. The objective of this study was to evaluate end-of-life care preferences of CKD patients to help identify gaps between current end-of-life care practice and patients' preferences and to help prioritize and guide future innovation in end-of-life care policy.Design, setting, participants, & measurements: A total of 584 stage 4 and stage 5 CKD patients were surveyed as they presented to dialysis, transplantation, or predialysis clinics in a Canadian, university-based renal program between January and April 2008.Results: Participants reported relying on the nephrology staff for extensive end-of-life care needs not currently systematically integrated into their renal care, such as pain and symptom management, advance care planning, and psychosocial and spiritual support. Participants also had poor self-reported knowledge of palliative care options and of their illness trajectory. A total of 61% of patients regretted their decision to start dialysis. More patients wanted to die at home (36.1%) or in an inpatient hospice (28.8%) compared with in a hospital (27.4%). Less than 10% of patients reported having had a discussion about end-of-life care issues with their nephrologist in the past 12 months.Conclusions: Current end-of-life clinical practices do not meet the needs of patients with advanced CKD.

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“…During cardiopulmonary resuscitation, it follows the universal ALS algorithm, and the dialysis access open for drug administration A shockable rhythm (VF/pulseless VT) is more common in patients undergoing haemodialysis than in the general population [25][26][27][28][29]. So the delay in delivering deibrillation must be minimised.…”

Section: Special Environmentmentioning

confidence: 99%

Cardiopulmonary Resuscitation in Special Circumstances

Cimpoeşu¹,

Popa²

2017

Resuscitation Aspects

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Cardiopulmonary resuscitation (CPR) in special circumstances includes the emergency intervention for special causes, special environments and special patients. Special causes cover the potential reversible causes of cardiac arrest that must be identiied or excluded during any resuscitation, divided into two groups, 4Hs and 4Ts: hypoxia, hypo-/hyperkalaemia and other electrolyte disorders, hypo-/hyperthermia, hypervolemia, tension pneumothorax, tamponade (cardiac), thrombosis (coronary or pulmonary) and toxins. The special environments section includes recommendations for the treatment of cardiac arrest occurring in speciic locations: cardiac surgery, catheterisation laboratory, dialysis unit, dental surgery, commercial airplanes or air ambulances, ield of play, diicult environment (e.g. drowning, high altitude, avalanche and electrical injuries) or mass casualty incident. CPR for special patients gives guidance for the patients with severe comorbidities (asthma, heart failure with ventricular assist devices, neurological disease and obesity) and pregnancy women or elderly people.

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Predictors and outcome of cardiopulmonary resuscitation (CPR) calls in a large haemodialysis unit over a seven-year period

Cited by 80 publications

References 17 publications

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

End-of-Life Care Preferences and Needs

Cardiopulmonary Resuscitation in Special Circumstances

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