Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis

Ippolito, Mariachiara; Catalisano, Giulia; Mariño, Claudia; Fucà, Rosa; Giarratano, Antonino; Baldi, Enrico; Einav, Sharon; Cortegiani, Andrea

doi:10.1016/j.resuscitation.2021.04.025

Cited by 33 publications

(23 citation statements)

References 31 publications

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“…Hayek et al reported data from a large multicenter registry from the United States and found that survival to hospital discharge was associated with patient age; for those younger than 45, survival was 21% compared to only 3% for those over the age of 80 [ 32 ]. A meta-analysis by Ippolito et al that included 7 studies with all patients receiving attempted resuscitation found an in-hospital survival rate of approximately 4% [ 41 ]. These low survival rates have led some to question the benefits of performing CPR on patients with COVID-19 [ 33 , 42 ].…”

Section: In-hospital Cardiac Arrestmentioning

confidence: 99%

Impact of Coronavirus Disease 2019 Pandemic on Cardiac Arrest and Emergency Care

Bharmal¹,

DiGrande²,

Patel³

et al. 2022

Cardiology Clinics

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Section: In-hospital Cardiac Arrestmentioning

confidence: 99%

Impact of Coronavirus Disease 2019 Pandemic on Cardiac Arrest and Emergency Care

Bharmal¹,

DiGrande²,

Patel³

et al. 2022

Cardiology Clinics

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“…The success of CPR relies on effective chest compression, which is defined as compressions with adequate rate, depth, and minimized interruptions by the International Liaison Committee on Resuscitation (4). With the pandemic of coronavirus disease 2019 (COVID- 19), increasing number of critically ill patients with COVID-19 need CPR (5). Since there is evidence for COVID-19 infection transmission during chest compressions, use of personal protective equipment (PPE) has been recommended for health care personnel involved in resuscitating of patients with confirmed or suspected COVID-19 (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

Cui

Jiang

2021

Front. Med.

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Background: Randomized controlled trials (RCTs) evaluating the influence of personal protective equipment (PPE) on quality of chest compressions during cardiopulmonary resuscitation (CPR) showed inconsistent results. Accordingly, a meta-analysis was performed to provide an overview.Methods: Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random-effect model incorporating the potential heterogeneity was used to pool the results.Results: Six simulation-based RCTs were included. Overall, pooled results showed that there was no statistically significant difference between the rate [mean difference (MD): −1.70 time/min, 95% confidence interval (CI): −5.77 to 2.36, P = 0.41, I2 = 80%] or the depth [MD: −1.84 mm, 95% CI: −3.93 to 0.24, P = 0.11, I2 = 73%] of chest compressions performed by medical personnel with and without PPE. Subgroup analyses showed that use of PPE was associated with reduced rate of chest compressions in studies before COVID-19 (MD: −7.02 time/min, 95% CI: −10.46 to −3.57, P < 0.001), but not in studies after COVID-19 (MD: 0.14 time/min, 95% CI: −5.77 to 2.36, P = 0.95). In addition, PPE was not associated with significantly reduced depth of chest compressions in studies before (MD: −3.34 mm, 95% CI: −10.29 to −3.62, P = 0.35) or after (MD: −0.97 mm, 95% CI: −2.62 to 0.68, P = 0.25) COVID-19. No significant difference was found between parallel-group and crossover RCTs (P for subgroup difference both > 0.05).Conclusions: Evidence from simulation-based RCTs showed that use of PPE was not associated with reduced rate or depth of chest compressions in CPR.

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“… 77 Additionally, there is a large debate on the outcomes of COVID-19 patients undergoing CPR. 78 Consultation of palliative care teams, when available, helped clarifying advance directives and minimize futile resuscitation efforts. 79 , 80 Some institutions registered an increase in palliative care consultations during COVID-19 outbreak 81 even though it is reported that palliative care consultations often happened late during hospitalization and in a minority of patients.…”

Section: Palliative Care and Covid-19mentioning

confidence: 99%

Palliative Care Principles and Anesthesiology Clinical Practice: Current Perspectives

Catalisano

Ippolito

Mariño

et al. 2021

JMDH

Self Cite

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Background Palliative care is a person-centered approach aiming to relieve patient’s health-related suffering and it is often needed when caring for critically ill patients to manage symptoms and identify goals of care. Aim To describe the integration of palliative care principles in anesthesiology clinical practice, within and outside the ICU and to analyze the additional challenges that COVID-19 pandemic is posing in this context. Methods For the purpose of this review, PubMed database was searched for studies concerning palliative care and end of life care, in contexts involving anesthesiologists and intensivists, published in the last 5 years. Results Anesthesiologists and intensivists integrate palliative care within their daily practice providing symptoms management as well as family counseling. High-quality communicational skills are fundamental for anesthesiologists and intensivists especially when interfacing with surrogate decision makers in the ICU or with patients in the preoperative setting while discussing goals of care. Coronavirus disease 2019 (COVID-19) pandemic has challenged many aspects of palliative care delivery: reduced family presence within the ICU, communication with families through phone calls or video calls, patient–physician relationship mediated by bulky personal protective equipment and healthcare workers physical and psychological distress due to the increased workload and limitations in resources are some of the most evident. Conclusion Anesthesiologists and intensivists are increasingly facing challenging clinical situations where principles and practice of palliative care have to be applied. In this sense, increasing knowledge on palliative care and providing specific training would allow to deliver high-quality symptom management, family counseling and end of life guidance in critical care settings. COVID-19 pandemic sets additional difficulties to palliative care delivery.

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Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis

Cited by 33 publications

References 31 publications

Impact of Coronavirus Disease 2019 Pandemic on Cardiac Arrest and Emergency Care

Impact of Coronavirus Disease 2019 Pandemic on Cardiac Arrest and Emergency Care

Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

Palliative Care Principles and Anesthesiology Clinical Practice: Current Perspectives

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