Survival from pulseless electrical activity after cardiopulmonary resuscitation in-hospitalazed patients

Introduction. Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation. The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator. Conclusion. Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.

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Cardiac arrest with pulseless electrical activity rhythm in newborn infants: a case series

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2018-316087 ◽

2019 ◽

Vol 104 (6) ◽

pp. F572-F574 ◽

Cited By ~ 10

Author(s):

Deandra Luong ◽

Po-Yin Cheung ◽

Keith J Barrington ◽

Peter G Davis ◽

Jennifer Unrau ◽

...

Keyword(s):

Heart Rate ◽

Cardiopulmonary Resuscitation ◽

Electrical Activity ◽

Activity Rhythm ◽

Healthcare Providers ◽

Newborn Infants ◽

Case Series ◽

Neonatal Resuscitation ◽

Pulseless Electrical Activity ◽

Resuscitation Guidelines

The 2015 neonatal resuscitation guidelines added ECG to assess an infant’s heart rate when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. We report four cases of pulseless electrical activity during neonatal cardiopulmonary resuscitation in levels II–III neonatal intensive care units in Canada (Edmonton [n=3] and Winnipeg [n=1]).Healthcare providers should be aware that pulseless electrical activity can occur in newborn infants during cardiopulmonary resuscitation. We propose an adapted neonatal resuscitation algorithm to include pulseless electrical activity. Furthermore, in compromised newborns, heart rate should be assessed using a combination of methods/techniques to ensure accurate heart rate assessment. When ECG displays a heart rate but the infant is unresponsive, pulseless electrical activity should be suspected and chest compression should be started.

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Continuous mechanical chest compression during in-hospital cardiopulmonary resuscitation of patients with pulseless electrical activity

Resuscitation ◽

10.1016/j.resuscitation.2010.10.019 ◽

2011 ◽

Vol 82 (2) ◽

pp. 155-159 ◽

Cited By ~ 26

Author(s):

Hendrik Bonnemeier ◽

Gregor Simonis ◽

Göran Olivecrona ◽

Britta Weidtmann ◽

Matthias Götberg ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Electrical Activity ◽

Chest Compression ◽

Pulseless Electrical Activity ◽

Mechanical Chest Compression

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Efficience of Cardiopulmonary Resuscitation in Emergency Medical Service and University Hospital

Acta Chirurgica Latviensis ◽

10.2478/chilat-2013-0001 ◽

2013 ◽

Vol 13 (1) ◽

pp. 3-6

Author(s):

Anita Kaleja ◽

Elina Snucina ◽

Indulis Vanags

Keyword(s):

Cardiac Arrest ◽

Survival Rate ◽

Cardiopulmonary Resuscitation ◽

Electrical Activity ◽

Pulseless Electrical Activity ◽

Complete Recovery ◽

Adult Patients ◽

University Hospital ◽

Short Term ◽

Hospital Cardiac Arrest

Summary Introduction.Survival rate among patients with cardiac arrest remains unclear. Return of spontaneous circulation (ROSC) is just the first step toward the goal of complete recovery from cardiac arrest. It depends on quality of cardiopulmonary resuscitation (CPR) during resuscitation and factors of postresuscitation care. Regular CPR analysis has not been carried out in Latvia. Aim of the study was to evaluate survival rate among patients with out-of-hospital cardiac arrest and in-hospital cardiac arrest. Materials and methods. The study was conducted in the State Emergency service of Latvia and Pauls Stradins Clinical University Hospital during 15 months in 2010/2011. There were 221 adult patients with in-hospital cardiac arrest and 162 adult patients with out-of-hospital cardiac arrest and performed CPR included in retrospective research. The information was analyzed by medical records. The obtained results were expressed in percents and compared, using the Pearson’s Chi-square (Pearson χ2) test. Results. The short-term ROSC was achieved among patients with out-of-hospital cardiac arrest (OHCA) in 62 cases and among patients with in-hospital cardiac arrest (IHCA) in 186 cases. Survival to discharge was achieved in 20.3% among patients with OHCA and 15.8% among patients with IHCA. The most commonly used CPR algorithm was pulseless electrical activity/asystole (72 - 73%). Short-term ROSC was achieved most frequently by ventricular fibrillation/pulseless ventricular tachycardia (41.3-56%), but the largest number of unsuccessful CPR episodes was observed by pulseless electrical activity/ asystole. Conclusion. Results of CPR were different among patients with OHCA and IHCA. ROSC is rhythm-specific outcome.

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