Review and Outcome of Prolonged Cardiopulmonary Resuscitation

Abstract

The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts.

Outcomes of cardiopulmonary resuscitation in the emergency department

“…The initial cardiac arrest rhythm was ventricular tachycardia or fibrillation in 41 cases (50%), and pulseless electrical activity or asystole in 37 cases (45%). In our study the most common rhythm was the asystole rhythm which is inconsistent with their result (15). The survival rate of CPR was 83% compared to 21% in our study.…”

Successful prolonged cardiopulmonary resuscitation for circulatory arrest followed by implantation of two mechanical cardiac support devices

“…1 Our case study shows the necessity for individually performed CPR, the recommended length of which is not clearly defi ned. 6 Particularly in relation to in-hospital cardiac arrest of younger individuals, there is a real possibility of the restitution of mental functions even after prolonged resuscitation. 2,7 As a supplementary phase, even an acute mechanical heart support device can be used as a bridge treatment for life-threatening conditions before arriving at a defi nite long-term solution, in our case a heart transplant.…”

Prolonged Successful Cardiopulmonary Resuscitation with Thrombolysis in a Patient with Acute Coronary Syndrome

“…В обзоре H. Youness с коллегами провели анализ результатов 491 из 3826 публикаций в PubMed в период с 1947 по 2013 гг. с продолжительностью СЛР более 20 мин [14]. Продолжительность СЛР у 82 пациентов колебалась от 20 до 330 мин (97,5±74,8).…”