Outcome of Cardiopulmonary Resuscitation in the Intensive Care Units of a University Hospital

Abstract

The purpose of this study is to evaluate the demographic characteristics of patients who suffered cardiac arrest in our ICUs and to identify those factors influencing outcome after resuscitation following cardiac arrest. We reviewed the records of all patients who underwent CPR in the two ICUs at the Georg-August University Hospital Goettingen, Germany from 1 January, 1999 to 31 December, 2003. During the study period 169 patients underwent CPR and 80 of the 169 patients survived to hospital discharge, giving a survival to hospital discharge rate of 47.3%. The initial monitored rhythm recorded at the time of arrest was asystole in 99 (58.6%) patients, ventricular tachycardia/fibrillation in 59 (34.9%) and pulseless electrical activity in 7 (4.1%) patients. The respective survival rates were 46 (54.8%), 31 (36.9%) and 5 (6.0%) to hospital discharge. Of the 80 patients that survived to hospital discharge 75 (93.8%) achieved good cerebral recovery (CPC 1 or 2) and were alert and fully oriented on discharge; 4 patients (5.0%) were severely disabled (CPC 3), while 1 (1.2%) remained unconscious and was reported dead five days after discharged to another local hospital. Illness severity as assessed by SAPS II score on admission was 38.8 +/- 16.0. None of our patients with > 40 SAPS II score 24 hours after CPR survived to be discharged from the ICU. Our study showed that nearly half the patients that had cardiac arrest in our hospital ICUs had a favourable outcome despite initial rhythms that are traditionally associated with a poor outcome. This confirms that good results are achievable in these groups of patients.

Predictors of survival after cardiac or respiratory arrest in critical care units

“…[8][9][10][11][12][13] In our study, about one in four patients (24.3%) survived to one year, and about one in six (15.9%) to five years. Survival was higher among our patients than among patients in previous studies whose arrest occurred in non-ICU hospital settings.…”

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation

“…2 Although patients with cardiac arrest due to ventricular fibrillation tend to respond more favorably to C-CPR compared with other etiologies of cardiac arrest, 1 outcome is poor if they fail to respond within the first 10 min. 4,5 Indeed, the reported survival rate is 20.4% in this scenario, with only 5.6% of patients regaining good neurological outcomes in out of hospital arrest. 6 A previous study suggests that using extracorporeal membrane oxygenation (ECMO) in extracorporeal CPR (E-CPR) can improve the clinical outcomes in patients with prolonged cardiac arrest beyond 10 min.…”

Survival and functional outcomes after cardiopulmonary resuscitation in the intensive care unit

“…However, ICU patients also usually have a higher severity or burden of illness at the time of CPA. Studies of general (multispecialty) ICU patients show that in-ICU CPR may result in return of circulation, but that survival to hospital discharge may range from 0% to 44% [16][17][18][19][20].…”