Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 27 , ISSUE 1 ( January, 2023 ) > List of Articles

Original Article

Factors Related to Resuscitation Success and Prognosis of Cardiopulmonary Arrest Cases

Fatih Cemal Tekin, Ramazan Köylü, Öznur Köylü, Muammer Kunt

Keywords : Clinical outcomes, Cardiopulmonary arrest, Prognosis, Resuscitation

Citation Information : Tekin FC, Köylü R, Köylü Ö, Kunt M. Factors Related to Resuscitation Success and Prognosis of Cardiopulmonary Arrest Cases. Indian J Crit Care Med 2023; 27 (1):26-31.

DOI: 10.5005/jp-journals-10071-24382

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: In cases where return of spontaneous circulation (ROSC) is provided in the Emergency Department (ED) after cardiopulmonary arrest (CA), it is important to investigate the parameters affecting ROSC rates, to determine the factors affecting the survival status and prognosis in the short and medium term, and to determine to what extent these factors affect the prognosis. Materials and methods: This is a cross-sectional study that retrospectively investigates the factors affecting the success of resuscitation over a 5-year period in out-of-hospital cardiac arrest (OHCA) cases. Results: We determined that ROSC was achieved in 26.1% of 1616 adult cardiopulmonary arrest cases, 14.8% survived the first 24 hours, and 3.8% were discharged from the hospital. Conclusion: We determined that ROSC decreased by 21% with a 1-mg increase in the amount of adrenaline used, by 98% with a 1 mmol/L increase in HCO3 (std) value, by 27% with a 1 mmol/L increase in BE (B) value, and by 15% with a 1 mmol/L increase in lactate value. In terms of short-term survival, we found that a 1 mmol/L increase in lactate value reduced the probability of survival by 12%, and a 1 mEq/L increase in K value decreased the probability by 29%. With regard to the probability of survival in the medium term, we determined that the growth in age by 1 year decreased the probability by 4%, and the increase in K value by 1 mEq/L decreased the probability by 35%.


PDF Share
  1. Hall JE, Guyton AC. Textbook of Medical Physiology. 11th ed. Philadelphia: Elsevier Saunders; 2006.
  2. Güler K, Çalangu S. Acil Dahiliye. 7.baskı. İstanbul: Nobel TıpKitabevi; 2009.
  3. Tanrıöver MD. Kardiyak Arrest Öncesinde Kötülesen Hastayi Tanimak: Öngörü Kriterlerive Risk Factörleri/Recognizing the deteriorating patient prior to cardiac arrest: Predictive criteria and risk factors. J Crit Intens Care 2011;2(1).
  4. Karataş M, Selçuk EB. Kardiyopulmoner resüsitasyonuntarihçesi. Kafkas Tıp Bilimleri Dergisi 2012;(2):84–87.
  5. Tintinalli J, Stapczynski JS, Ma OJ, Cline D, Cydulka R, Meckler G. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed., New York: McGraw-Hill Medical; 2012.
  6. Welbourn C, Efstathiou N. How does the length of cardiopulmonary resuscitation affect brain damage in patients surviving cardiac arrest? A systematic review. Scand J Trauma Resusc Emerg Med 2018;26(1):77. DOI: 10.1186/s13049-018-0476-3.
  7. Aitchison R, Aitchison P, Wang E, Kharasch M. A review of cardiopulmonary resuscitation and its history 2013 [cited 31 August 2021]. Available from: http://dx.doi.org/10.1016/j.disamonth.2013. 03.002.
  8. Walls RM, Hockberger RS, Gausche-Hill M. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed., Philadelphia: Elsevier; 2018.
  9. Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, et al. Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020;142(16 suppl 2): 337–357.
  10. Gräsner JT, Herlitz J, Tjelmeland IBM, Wnent J, Masterson S, Lilja G, et al. European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation 2021;161:61–79. DOI: 10.1016/j.resuscitation.2021.02.007.
  11. Cardiac Arrest: An Important Public Health Issue [cited 28 July 2021]. Available from: https://www.cdc.gov/features/learn-cpr/index.html.
  12. Peberdy MA, Kaye W, Ornato JP, Larkin GL, Nadkarni V, Mancini ME, et al. Cardiopulmonary resuscitation of adults in the hospital: A report of 14 720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2003;58(3):297–308. DOI: 10.1016/s0300-9572(03)00215-6.
  13. Tagami T, Hirata K, Takeshige T, Matsui J, Takinami M, Satake M, et al. Implementation of the fifth link of the chain of survival concept for out-of-hosp. Circulation 2012;126(5):589–597. DOI: 10.1161/CIRCULATIONAHA.111.086173.
  14. Petrie DA, De Maio V, Stiell IG, Dreyer J, Martin M, O'brien JA. Factors affecting survival after prehospital asystolic cardiac arrest in a Basic Life Support–defibrillation system. CJEM 2001;3(3):186–192. DOI: 10.1017/s1481803500005522.
  15. Ebell MH, Jang W, Shen Y, Geocadin RG. Development and validation of the good outcome following attempted resuscitation (GO-FAR) score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation. JAMA Intern Med 2013;173(20):1872–1878. DOI: 10.1001/jamainternmed.2013.10037.
  16. van Gijn MS, Frijns D, van de Glind EM, van Munster BC, Hamaker ME. The chance of survival and the functional outcome after in-hospital cardiopulmonary resuscitation in older people: A systematic review. Age Ageing 2014;43(4):456–463. DOI: 10.1093/ageing/afu035.
  17. Sandroni C, Nolan J, Cavallaro F, Antonelli M, Sandroni C, Cavallaro F, et al. In-hospital cardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med 2007;33(2):237–245. DOI: 10.1007/s00134-006-0326-z.
  18. Høybye M, Stankovic N, Holmberg M, Christensen HC, Granfeldt A, Andersen LW. In-hospital vs. out-of-hospital cardiac arrest: Patient characteristics and survival. Resuscitation 2021;158:157–165. DOI: 10.1016/j.resuscitation.2020.11.016.
  19. Paradis NA, Halperin HR, Kern KB, Wenzel V, Chamberlain DA. Cardiac Arrest the Science and Practice of Resuscitation Medicine.
  20. Mody P, Pandey A, Slutsky AS, Segar MW, Kiss A, Dorian P, et al. Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest. Circulation 2021;143(7):641–649. DOI: 10.1161/CIRCULATIONAHA.120.050427.
  21. Moosajee US, Saleem SG, Iftikhar S, Samad L. Outcomes following cardiopulmonary resuscitation in an emergency department of a low- and middle-income country. Int J Emerg Med 2018;11(1):40. DOI: 10.1186/s12245-018-0200-0.
  22. Araç S, Zengin Y, İçer M, Gündüz E, Dursun R, Durgun H, et al. AcilServiste Kardiyopulmoner Resüsitasyon Yapılan Hastaların Değerlendirilmesi; Retrospektif Çalışma. Abant Tıp Dergisi 2021; 10(1):140–151. DOI: 10.47493/abantmedj.2021.44.
  23. Ramazani J, Hosseini M. Prediction of mortality in the medical intensive care unit with serial full outline of unresponsiveness score in elderly patients. Indian J Crit Care Med 2022;26(1):94–99. DOI: 10.5005/jp-journals-10071-24094.
  24. Anushiravani A, Masoompour SM. Assessing the performance of a medical intensive care unit: A 5-year single-center experience. Indian J Crit Care Med 2017;21(3):163–166. DOI: 10.4103/ijccm.IJCCM_420_16.
  25. Maupain C, Bougouin W, Lamhaut L, Deye N, Diehl JL, Geri G, et al. The CAHP (Cardiac Arrest Hospital Prognosis) score: A tool for risk stratification after out-of-hospital cardiac arrest. Eur Heart J 2016; 37(42):3222–3228. DOI: 10.1093/eurheartj/ehv556.
  26. Yamanoğlu A. Kan gazıanalizininhastaneiçikardiyakarrestlerde kardiyopulmoner resüsitasyonunsonucunubelirlemedekideğerliliği. Cumhuriyet Med J 2020;42(3):366–374.
  27. Altınbilek E, Çalık M, Tümer M, Erdem AB, Öztürk D. Retrospective evaluation of patients undergoing cardiopulmonary resuscitation in the Emergency Department. J Acad Res Med 2020;10(3):264–268. DOI: 10.4274/jarem.galenos.2020.3764.
  28. Yanagawa Y, Sakamoto T, Sato H. Relationship between laboratory findings and the outcome of cardiopulmonary arrest. Am J Emergency Med 2009;27(3):308–312. DOI: 10.1016/j.ajem.2008.03.001.
  29. Delmas C, Conil J, Sztajnic S, Georges B, Biendel C, Dambrin C, et al. Early prediction of 3-month survival of patients in refractory cardiogenic shock and cardiac arrest on extracorporeal life support. Indian J Crit Care Med. 2017;21(3):138–145. DOI: 10.4103/ijccm.IJCCM_32_17.
  30. Umei N, Shingo I, Ujike Y, Yumoto T, Ida A, Hirayama T, et al. Predicting the return of spontaneous circulation after out-of-hospital cardiac arrest through blood gas analysis. Int J Gerontol 2009;3(Suppl 1):A206. DOI: 10.1186/2197-425X-3-S1-A206.
  31. George N, Thai TN, Chan PS, Ebell MH. Predicting the probability of survival with mild or moderate neurological dysfunction after in-hospital cardiopulmonary arrest: The GO-FAR 2 score. Resuscitation 2020;146:162–169. DOI: 10.1016/j.resuscitation.2019.12.001.
  32. Ebell MH, Jang W, Shen Y, Geocadin RG; Get with the Guidelines–Resuscitation Investigators. Development and validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) 56 score to predict neurologically intact score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation. JAMA Intern Med 2013;173(20):1872–1878. DOI: 10.1001/jamainternmed.2013.10037.
  33. Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PWB. The impact of the use of the Early Warning Score (EWS) on patient outcomes: A systematic review. Resuscitation 2014;85(5):587–594. DOI: 10.1016/j.resuscitation.2014.01.013.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.