Family Presence at First Cardiopulmonary Resuscitation and Subsequent Limitations on Care in the Medical Intensive Care Unit

Abstract

For unclear reasons, family-witnessed CPR in the medical intensive care unit is associated with a similar rate of subsequent CPR efforts and lower rates of return of spontaneous circulation and survival to hospital discharge.

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

“…[388][389][390][391][392]399,404,406,407,411,414,416 Four studies compared family presence with no family presence. [388][389][390]404 Only 1 study found higher rates of ROSC and survival to discharge when no family members were present during resuscitation. 389 2.…”

“…[388][389][390]404 Only 1 study found higher rates of ROSC and survival to discharge when no family members were present during resuscitation. 389 2. Family outcomes were reported in 15 studies 387,388,[391][392][393][394][395]403,[405][406][407][408]411,414,416 investigating depression, anxiety, posttraumatic stress disorder, and experience of witnessing the resuscitation of a family member.…”

Family ward rounds in intensive care: An integrative review of the literature

“…Family presence has also been preferred by patients who have gone through cardiac resuscitation (Bradley, Keithline, Petrocelli, Scanlon & Parkosewich, 2017;Krochmal et al, 2017). Our review highlighted the moderate quality of evidence to demonstrate the impact of family presence in rounds on family and patient-centered outcomes.…”

Humanization of critical care—psychological effects on healthcare professionals and relatives: a systematic review

“…104 A retrospective study of more than 300 patients in a medical intensive care unit showed significantly lower rates of return of spontaneous circulation and survival to hospital discharge for patients whose families were present during cardiopulmonary resuscitation. 105 Although these results are not consistent across studies, they do raise an important issue. While humanization is innately right, it does not necessarily follow that all efforts to optimize it should be pursued without considering the risk-benefit balance.…”