Outcomes of Cardiopulmonary Resuscitation and Its Predictors in Hospitalized Patients

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Meisam Moezzi ◽  
Golshan Afshari ◽  
Fakher Rahim ◽  
Meysam Alavian ◽  
Maryam Banitorfi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Success Rate ◽  
Age Groups ◽  
Medical Intervention ◽  
Success Rates ◽  
Significant Difference ◽  
And Gender ◽  
Evening Shift ◽  
Hospital Cardiac Arrest

Background: Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person stricken by cardiac arrest, and there is an excellent value of diversity in the rate of successful rehabilitation in societies. Methods: A retrospective observational study was carried out. The medical records of all in-hospital and out-hospital cardiac arrest patients who underwent CPR were collected. A total of 587 people with who underwent CPR during two years between January 2017 and June 2018, using a designed form were enrolled. Demographic information, the ward which CPR was committed, hospitalization, the delay before the onset of CPR and time of the day were recorded. Results: The overall success rate of CPR in this study was 25.89%. There was no significant difference in the success rate of CPR between men and women. A comparison of age groups revealed a difference between the success rates of CPR in 14 - 64 years group compared with the group above 64. Analysis of the data revealed no difference between CPR success rates in various seasons. Investigating the occurrence of cardiac arrest and its success rate at the hospital shifting showed a significant difference between the success rate of CPR in the morning shift with the evening shift and night. The dual comparison revealed a significant difference in the success rate of CPR only between the emergency department and intensive care units. Conclusions: The current study revealed a significant difference in age group and location, and did not show any significant success rate of CPR in the presence of witnesses, location of cardiac arrest, season and gender.

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 372-381
Author(s):  
Junhong Wang ◽  
Hua Zhang ◽  
Zongxuan Zhao ◽  
Kaifeng Wen ◽  
Yaoke Xu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Significant Difference ◽  
Bystander Cardiopulmonary Resuscitation ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

Abstract 13027: Investigating the Airway Opening Index During Cardiopulmonary Resuscitation

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Shiv Bhandari ◽  
Jason Coult ◽  
Natalie Bulger ◽  
Catherine Counts ◽  
Heemun Kwok ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Study ◽  
Cardiopulmonary Resuscitation ◽  
Statistical Significance ◽  
Chest Compressions ◽  
Airway Patency ◽  
Significant Difference ◽  
Airway Opening ◽  
Automated Methods ◽  
Hospital Cardiac Arrest

Introduction: In 40-70% of out-of-hospital cardiac arrest (OHCA) cases, chest compressions (CCs) during CPR induce measurable oscillations in capnography (E T CO 2 ). Recent studies suggest the magnitude and frequency of oscillations are due to intrathoracic airflow dependent on airway patency. These oscillations can be quantified by the Airway Opening Index (AOI), ranging from 0-100%. We sought to develop, automate, and evaluate multiple methods of computing AOI throughout CPR. Methods: We conducted a retrospective study of all OHCA cases in Seattle, WA during 2019. E T CO 2 and impedance waveforms from LifePak 15 defibrillators were annotated for the presence of intubation and CPR, and imported into MATLAB for analysis. Four proposed methods for computing AOI were developed (Fig. 1) using peak E T CO 2 in conjunction with ΔE T CO 2 (oscillations in E T CO 2 from CCs). We examined the feasibility of automating ΔE T CO 2 and AOI calculation during CCs throughout OHCA resuscitation and evaluated differences in mean AOI using each method. Statistical significance was assessed with ANOVA (alpha = 0.05). Results: AOI was measurable in 312 of 465 cases. Mean [95% confidence interval] AOI across all cases was 34.3% [32.0-36.5%] for method 1, 27.6% [25.5-29.7%] for method 2, 22.7% [21.1-24.3%] for method 3, and 28.8% [26.6-31.0%] for method 4. Mean AOI was significantly different across the four methods (p<0.001), with the greatest difference between method 1 and 3 (11.6%, p<0.001), but no significant difference between methods 2 and 4 (p=0.44). Mean ΔE T CO 2 was 7.76 [7.08-8.44] mmHg. Conclusion: We implemented four proposed methods of automatically calculating AOI during OHCA. Each method produced a different average AOI. Consistent, automated methods to measure AOI provide the foundation to evaluate if, and how, AOI may change with treatment or predict outcomes. These four approaches require additional investigation to understand which may be best suited to improve OHCA care.

scholarly journals Extracorporeal Cardiopulmonary Resuscitation (ECPR) for Out-of-Hospital Cardiac Arrest due to Pulseless Ventricular Tachycardia/Fibrillation

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Konstantinos Dean Boudoulas ◽  
Bryan A. Whitson ◽  
David P. Keseg ◽  
Scott Lilly ◽  
Cindy Baker ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Cardiopulmonary Resuscitation ◽  
Medical Center ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Neurologic Recovery ◽  
Cardiac Catheterization Laboratory ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hospital Cardiac Arrest

Background. Survival rates for out-of-hospital cardiac arrest are very low and neurologic recovery is poor. Innovative strategies have been developed to improve outcomes. A collaborative extracorporeal cardiopulmonary resuscitation (ECPR) program for out-of-hospital refractory pulseless ventricular tachycardia (VT) and/or ventricular fibrillation (VF) has been developed between The Ohio State University Wexner Medical Center and Columbus Division of Fire. Methods. From August 15, 2017, to June 1, 2019, there were 86 patients that were evaluated in the field for cardiac arrest in which 42 (49%) had refractory pulseless VT and/or VF resulting from different underlying pathologies and were placed on an automated cardiopulmonary resuscitation device; from these 42 patients, 16 (38%) met final inclusion criteria for ECPR and were placed on extracorporeal membrane oxygenation (ECMO) in the cardiac catheterization laboratory (CCL). Results. From the 16 patients who underwent ECPR, 4 (25%) survived to hospital discharge with cerebral perfusion category 1 or 2. Survivors tended to be younger (48.0 ± 16.7 vs. 59.3 ± 12.7 years); however, this difference was not statistically significant (p=0.28) likely due to a small number of patients. Overall, 38% of patients underwent percutaneous coronary intervention (PCI). No significant difference was found between survivors and nonsurvivors in emergency medical services dispatch to CCL arrival time, lactate in CCL, coronary artery disease severity, undergoing PCI, and pre-ECMO PaO2, pH, and hemoglobin. Recovery was seen in different underlying pathologies. Conclusion. ECPR for out-of-hospital refractory VT/VF cardiac arrest demonstrated encouraging outcomes. Younger patients may have a greater chance of survival, perhaps the need to be more aggressive in this subgroup of patients.

scholarly journals Development and validation of a questionnaire to assess knowledge, attitude and confidence regarding cardiopulmonary resuscitation among ambulance drivers in Malaysia

2019 ◽  
Vol 10 (4) ◽  
pp. 2973-2982
Author(s):  
Jamie Foong Siew Wei ◽  
Mohd Azmani bin Sahar ◽  
Ahmad Zulkarnain Ahmad Zahedi
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Prehospital Care ◽  
Critical Role ◽  
Educational Background ◽  
Medical Intervention ◽  
Face Validity ◽  
Good Test ◽  
Test Retest Reliability ◽  
Hospital Cardiac Arrest

Out of hospital cardiac arrest is a major cause of death worldwide. The outcome from out of hospital cardiac arrest remains poor, thus requiring immediate emergency medical intervention and high-quality cardiopulmonary resuscitation. Ambulance drivers are part of the prehospital care team and therefore play a critical role in providing cardiopulmonary resuscitation to cardiac arrest patient. As present, there is no study that has been developed to assess the knowledge, attitude and confidence regarding cardiopulmonary resuscitation among ambulance drivers. Thus, this study has developed a reliable and validated a questionnaire called AmKAC to evaluate their knowledge, attitude and confidence. The questionnaires are available in two languages, English and Bahasa Malaysia, in view of different educational background. The content validity was then assessed by content experts. Subsequently, the questionnaires underwent face validity which were pretested among 10 ambulance drivers to check for the understanding, language and readability. Afterwards, the refined questionnaires were administered to 108 ambulance drivers from the emergency trauma department of six different hospitals. The process was repeated one week after for the retest. This study reviewed reliable questionnaires in measuring knowledge, attitude and confidence among ambulance driver with Cronbach’s alpha of 0.685, 0.703 and 0.905, respectively. In addition, the questionnaire also showed good test-retest reliability and correlation between the items, by using Spearman’s rho and intraclass coefficient, respectively. In conclusion, the developed, validated AmKAC can be used in future to provide better insights of the ambulance drivers knowledge, attitude and confidence level regarding cardiopulmonary resuscitation permitting organization of courses and training.  

scholarly journals Factors Affecting a Successful Out-Of-Hospital Cardiopulmonary Resuscitation / Pirmsslimnīcas Etapa Kardiopulmonālo Reanimāciju Rezultātus Ietekmējošie Faktori

2014 ◽  
Vol 68 (5-6) ◽  
pp. 228-231
Author(s):  
Kaspars Setlers ◽  
Indulis Vanags ◽  
Anita Kalēja
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Admission ◽  
Heart Rhythm ◽  
Patient Characteristics ◽  
Spontaneous Circulation ◽  
Factors Affecting ◽  
Bystander Cpr ◽  
And Gender ◽  
Hospital Cardiac Arrest

Abstract A retrospective patient record analysis of the Emergency Medial Service’s Rîga City Regional Centre was provided from January 2012 through December 2013. 1359 adult patients were CPR treated for out-of-hospital cardiac arrest according to ERC Guidelines 2010. A total of 490 patients were excluded from the study. The main outcome measure was survival to hospital admission. Of 869 CPR-treated patients, 60% (n = 521) were men. The mean age of patients was 66.68 ± 15.28 years. The survival rate to hospital admission was 12.9% (n = 112). 54 of survived patients were women. Mean patient age of successful CPR was 63.22 ± 16.21 and unsuccessful CPR 67.20 ± 15.09. At least one related illness was recorded with 63.4% (n = 551) patients. There were 61 survivors in bystander witnessed OHCA and nine survivors in unwitnessed OHCA. The rate of bystander CPR when CA (cardiac arrest) was witnessed was 24.8%. Ventricular fibrillation (VF) as initial heart rhythm was significantly associated with survival to hospital admission in 54 cases (p < 0.0001). Age and gender affected return of spontaneous circulation. Survival to hospital admission had rhythm-specific outcome. Presence of OHCA witnesses improved outcome compared to bystander CPR. The objective of this study was to report patient characteristics, the role of witnesses in out-of-hospital cardiac arrest (OHCA) and outcome of adult cardiopulmonary resuscitation

scholarly journals Comparative Study of Mechanical and Manual Compression in the Resuscitation of Patients with Out-of-hospital Cardiac Arrest

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Bing Han ◽  
Lan Hong
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Success Rate ◽  
Small Error ◽  
Control Group ◽  
Observation Group ◽  
Manual Compression ◽  
Blood Oxygen Saturation ◽  
Bare Hand ◽  
Hospital Cardiac Arrest

Objective: To analyze the effect of mechanical and manual compression on the resuscitation effect of out-of-hospital cardiac arrest patients. Methods: The 40 trained medical personnel who are skilled in bare hand compression and cardiopulmonary resuscitation machines were divided into two groups with 20 people in each group. The control group consists of a bare hand compression group while the observation group consists of cardiopulmonary resuscitation group. The two groups of people performed heart compression on the simulated person and observe the effect of the two compression methods on the patient during the cardiac arrest operation. Results: The resuscitation success rate in the control group was 65%, the resuscitation success rate in the observation group was 90%. The systolic blood pressure, heart rate, blood oxygen saturation, the accuracy rate of compression depth frequency, and interruption time in the observation group (cardiac resuscitation compression group) were significantly better than the control group (bare hand compression group). Conclusion: The use of mechanical compression has a small error rate, a high success rate, saves time and effort, and can effectively help patients. It is worth promoting and applying.

Abstract 126: Intravenous Versus Intraosseous Epinephrine Administration for Pediatric Patients with Out-of-hospital Cardiac Arrest

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Masashi Okubo ◽  
Cameron Dezfulian ◽  
Francis X Guyette ◽  
Christian Martin-Gill ◽  
Sylvia Owusu-Ansah ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Propensity Score ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Discharge ◽  
Pediatric Patients ◽  
Propensity Score Analysis ◽  
Epinephrine Administration ◽  
Significant Difference ◽  
Hospital Cardiac Arrest

Introduction: The 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation recommend intravenous (IV) or intraosseous (IO) epinephrine administration for pediatric patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether the route of epinephrine administration affects patient outcomes. Our objective was to evaluate the association between the route of epinephrine administration and survival. Methods: We conducted a secondary analysis of the Resuscitation Outcomes Consortium Epistry, a prospective multicenter OHCA registry from 2011 through 2015 in North America. We included pediatric patients (≤18 years) with OHCA for whom emergency medical services (EMS) providers attempted resuscitation and administered epinephrine via IV or IO. We excluded patients who received endotracheal epinephrine, received both IV and IO epinephrine, received IV epinephrine with failed IO access, and received IO epinephrine with failed IV access. The primary outcome was survival to hospital discharge. We used multivariable logistic regression and adjusted for age, sex, initial rhythm, location of arrest, witness status, receiving layperson cardiopulmonary resuscitation, 9-1-1 call to EMS arrival, and advanced airway management. We also conducted a propensity score matching analysis with the same covariates. Results: Of the eligible 831 pediatric patients with OHCA, 226 (27.2%) received IV epinephrine and 605 (72.8%) IO epinephrine. Median interval between 9-1-1 call and epinephrine administration was 16.4 minutes (interquartile range [IQR] 12.9-21.0) in IV group and 16.2 minutes (IQR 12.8-20.0) in IO group. In the logistic regression model, the adjusted odds ratio (OR) of the IO group for survival to hospital discharge was 0.99 (95% confidence interval [CI] 0.41-2.40), compared with the IV group. Similarly, in the propensity score analysis, 218 patients underwent matching with good balance (standardized differences <0.25 for all covariates) and the OR of the IO group for survival to hospital discharge was 1.00 (95% CI 0.38-2.62). Conclusions: We observed no significant difference in survival to hospital between pediatric patients with OHCA who received epinephrine via IV and IO routes.

5225Bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest of non-cardiac origin

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D M Christensen ◽  
S Rajan ◽  
K Kragholm ◽  
K B Sondergaard ◽  
O M Hansen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Ohca Patient ◽  
Significant Difference ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Study Population ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

Abstract Background Knowledge about the effect of bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) of non-cardiac origin is lacking. We aimed to investigate the association between bystander CPR and survival in OHCA of presumed non-cardiac origin. Methods From the Danish Cardiac Arrest Registry and through linkage with national Danish healthcare registries we identified all adult patients with OHCA of presumed non-cardiac origin in Denmark (2001–2014). These were categorized further into OHCA of medical and non-medical cause. We analyzed temporal trends in bystander CPR and 30-day survival during the study period. Multiple logistic regression was used to examine the association between bystander CPR and 30-day survival and reported as standardized 30-day survival chances with versus without bystander CPR standardized to the prehospital OHCA-factors and patient characteristics of all patients in the study population. Results We identified 10,761 OHCAs of presumed non-cardiac origin. Bystander CPR was associated with an increased 30-day survival chance of 3.4% (95% confidence interval [CI]: 2.9–3.9) versus 1.8% (95% CI: 1.4–2.2) with no bystander CPR, corresponding to a significant difference of 1.6% (95% CI: 0.9–2.3). During the study period, the overall bystander CPR rates increased from 13.6% (95% CI: 11.2–16.5) to 62.7% (95% CI: 60.2–65.2). 30-day survival increased overall from 1.3% (95% CI: 0.7–2.6) to 4.0% (95% CI: 3.1–5.2). Similar findings were observed in subgroups of medical and non-medical OHCA. Table 1. Patient and arrest characteristics according to cause of out-of-hospital cardiac arrest Overall Medical OHCA Non-medical OHCA Patient characteristics   Total patients 10761 7625 3136   Median age,y 67 70 50   Male, n (%) 6357 (59.1) 4154 (54.5) 2204 (70.4) OHCA factors   Witnessed arrest, n (%) 4306 (40.0) 3574 (46.9) 732 (23.3)   Public location, n (%) 6979 (64.9) 5494 (72.1) 1485 (47.4) OHCA, out-of-hospital cardiac arrest; CPR, cardiopulmonary resuscitation. Figure 1. Temporal trends Conclusion Bystander CPR was associated with a higher chance of 30-day survival among OHCA of presumed non-cardiac origin regardless of the underlying cause (medical/non-medical). Rates of bystander CPR and 30-day survival improved during the study period.

scholarly journals Evaluation of Cardiopulmonary Resuscitation and Underlying Medical Conditions in Hospitalized Patients

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Meisam Moezzi ◽  
Mostafa Alavi ◽  
Golshan Afshari ◽  
Nasrin Fatemi
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Success Rate ◽  
Cardiac Rhythm ◽  
Underlying Disease ◽  
Success Rates ◽  
Case Histories ◽  
Patient Case ◽  
Significant Difference ◽  
Medical Histories ◽  
Practical Factors

Background: A critical, therapeutic interference that develops the opportunity of survival is cardiopulmonary resuscitation (CPR). One of the practical factors resulting from resuscitation is the presence or absence of underlying disorders in patients. Objectives: This experiment aims to evaluate the primary disease and success rate of resuscitation. Methods: This study was an observational retrospective study; the therapeutic histories of all patients who sustained CPR were collected. A total of 587 patient case histories, who were supported with in Hospital CPR within two years from January 2017 to June 2018, were enrolled in the current investigation. The association of CPR success rate with underlying disease, the first cardiac rhythm observed after monitoring, and the use of cardiac defibrillator was investigated. Results: Overall, the success valuation of CPR in this investigation was 26.3%. There was no notable correlation between the success rate of CPR, and the early detection of cardiac rhythm after monitoring and using a cardiac defibrillator. Past medical histories reported a difference among the success rates of CPR in patients with hypertension, diabetes, and cardiac and renal disease. Conclusions: The current study revealed a significant difference in past medical histories and CPR outcomes.

scholarly journals Gender and survival from out-of-hospital cardiac arrest: a New Zealand registry study

2018 ◽  
Vol 35 (6) ◽  
pp. 367-371 ◽  
Author(s):  
Bridget Dicker ◽  
Kate Conaglen ◽  
Graham Howie
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
New Zealand ◽  
Spontaneous Circulation ◽  
Logistic Regression Models ◽  
Significant Difference ◽  
Outcome Differences ◽  
And Gender ◽  
Using Data ◽  
Hospital Cardiac Arrest

ObjectiveTo determine the relationships between survival from all-cause out-of-hospital cardiac arrest (OHCA) and gender in New Zealand.MethodsA retrospective observational study was conducted using data compliant with the Utstein guidelines from the St John New Zealand OHCA Registry for adult patients who were treated for an OHCA between 1 October 2013 and 30 September 2015. Univariate logistic regression was used to investigate factors associated with return of spontaneous circulation sustained to handover at hospital and survival to 30 days. Multivariate logistic regression models were used to investigate outcome differences in survival according to gender at 30 days postevent.ResultsWomen survived to hospital handover in 29% of cases, which was not significantly different from men (31%). When adjusted for age, location, aetiology, initial rhythm and witnessed status, there was no significant difference in 30-day survival between men (16%) and women (13%) (adjusted OR 1.22, 95% CI (0.96 to 1.55), p=0.11).ConclusionNo statistical differences were found in 30-day survival between genders when adjustments for unfavourable Utstein variables were accounted for.

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