Factors Affecting Outcome following Cardiopulmonary Resuscitation

Abstract

Many patients who receive cardiopulmonary resuscitation (CPR) for cardiac arrest do not survive to leave hospital. Factors associated with adverse outcomes include unwitnessed cardiac arrest in general wards, particularly at night, prolonged resuscitation, asystole, associated disorders (e.g. sepsis, malignancy, renal failure, and left ventricular dysfunction), absent pupillary responses, hypoxaemia, low PetCO2 during resuscitation, and severe acid base imbalance. Outside hospitals, cardiac arrests result in more favourable outcomes if they occur at work, and bystander CPR and early defibrillation are initiated. On admission to ICU, likely predictors of death or severe neurological disability include prolonged coma, impaired brainstem reflexes, and persistent convulsions. Experience with cerebrospinal fluid enzymes and electrophysiological measurements is limited. Multivariate scoring systems are not sufficiently reliable. The importance of hyperglycaemia, the required level of CPR training, and the appropriateness of responding to some cases, remain debatable.

Retracted: Cardiopulmonary resuscitation: Outcome and its predictors among hospitalized elderly patients in Egypt

“…There is only one study that discussed the number of cardiac arrests that the patient experienced before and its effect on the outcome of CPR, and they found that it was not a significant factor; 24 this agrees with the present study findings.…”

Cardiopulmonary resuscitation: a retrospective review

“…This demonstrates a specific, but not very sensitive, indicator of survival and suggests that pooling several variables may be helpful in predicting outcome. These findings also suggest that neurological function is a very important determinant of outcome and that more sensitive neurophysiological testing might be a useful prognostic tool [3,13].…”

“…The prognosis of patients who survive the initial resuscitation after a cardiac arrest is often thought to be poor, in terms of both mortality and morbidity [1][2][3]. However, there is little published work from the United Kingdom to confirm or refute this view.…”

Outcome after heroin overdose and cardiopulmonary resuscitation

“…After an acute drug poisoning leading to cardiac arrest and successful resuscitation, low blood glucose levels were measured using capillary blood in four patients, two pre‐hospitally and two in the ED. Hyperglycaemia, rather than hypoglycaemia, is a common finding in patients resuscitated from cardiac arrest (19–22). Morphine’s ability to induce hyperglycaemia in humans has been reported previously (23).…”