Cardiopulmonary resuscitation of adults with in-hospital cardiac arrest using the Utstein style

Abstract

ObjectiveThe objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style.MethodsThis study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year.ResultsThe study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59.0 years. The episodes occurred during the daytime in 64.6% of cases. Asystole/bradyarrhythmia was the most frequent initial rhythm (42.7%). Most patients who exhibited a spontaneous return of circulation experienced recurrent cardiac arrest, especially within the first 24 hours (61.4%). The mean time elapsed between hospital admission and the occurrence of cardiac arrest was 10.3 days, the mean time between cardiac arrest and cardiopulmonary resuscitation was 0.68 min, the mean time between cardiac arrest and defibrillation was 7.1 min, and the mean duration of cardiopulmonary resuscitation was 16.3 min. Associations between gender and the duration of cardiopulmonary resuscitation (19.2 min in women versus 13.5 min in men, p = 0.02), the duration of cardiopulmonary resuscitation and the return of spontaneous circulation (10.8 min versus 30.7 min, p < 0.001) and heart disease and age (60.6 years versus 53.6, p < 0.001) were identified. The immediate survival rates after cardiac arrest, until hospital discharge and 6 months after discharge were 71%, 9% and 6%, respectively.ConclusionsThe main initial rhythm detected was asystole/bradyarrhythmia; the interval between cardiac arrest and cardiopulmonary resuscitation was short, but defibrillation was delayed. Women received cardiopulmonary resuscitation for longer periods than men. The in-hospital survival rate was low.

Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial

“…It is known that patient mortality may vary greatly between institutions and countries [34]. As shown in Table 4, the overall ROSC rate (55%) in this study was similar to prior reports from Iran (20%–56%) [7, 35–37], Brazil (71%) [38], USA (43%–52%) [39, 40], Europe (54%–73%) [41–44], Turkey (49%) [45], Japan (65%) [46], and Taiwan (58%–67%) [47, 48] and greater than China (36%) [49], Hong Kong (38%) [50], and Australia and New Zealand (46%) [51]. Although the overall discharge survival rate was higher than previous cohorts, this was due to improved survival in the experimental group.…”

“…Moreover, female sex and lower age have been associated with improved odds of IHCA survival, whereas black race has been associated with decreased survival [40, 52, 53]. Although the sex distribution in this study is consistent with Iran’s national census data, the proportion of females in our study was higher than other published cohorts [38, 40, 42, 44, 50, 53, 54]. Additionally, the mean age in our cohort was slightly lower than that in some prior reports (Table 7) [35, 42, 44, 45, 47–50, 54–56].…”

Identification of warning signs for prevention of in-hospital cardiorespiratory arrest

“…This can be attributed to the fact that the present study was carried out in a university hospital with a large contingent of professionals. Regarding the time between onset and end of CPR, this interval in the studied sample (16.1 ‘) was similar to that of another study performed in an ICU (16.3’) 18 .…”

“…In this study, the mean time interval in minutes between collapse and onset of CPR (0.8’), between onset of CPR and defibrillation (9.4’), and between onset of CPR and clearance of UAW (5.5’) were higher than those observed in a prospective study performed in an ICU in Minas Gerais, which presented means of 0.7’; 7.1’; and 4.8’, respectively 18 . This may be related to the fact that this study was performed in an Emergency Service, which may imply a delay in the monitoring of patients presenting CRA, different from the intensive care setting where patients are already monitored.…”

Standardization of drugs in emergency trolleys in intensive care and emergency units

“…The intra-hospital CRA in adults presents a worldwide incidence of 1.6/1,000 admissions, of which 52% occur in the ICU, with a survival rate of 18.4%. However, in Brazil, in a multicenter study with 763 patients with CRA, 360 occurred in the ICU and in the coronary care unit, with a survival rate of 13% until hospital discharge, thus creating a better outcome for the CRA occurred in this sector (Silva, Silva, Silva, & Amaral, 2016). When the event occurs, immediate care is delivered by a multidisciplinary team, but also life support is provided, including the ready use of the emergency trolley.…”