Survival with good neurological outcome in a patient with prolonged ischemic cardiac arrest-Utility of automated chest compression systems in the cardiac catheterization laboratory

2014 ◽  
Vol 84 (6) ◽  
pp. 987-991 ◽  
Author(s):  
Peter J. Psaltis ◽  
Ian T. Meredith ◽  
Walid Ahmar
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Chest Compression ◽  
Neurological Outcome ◽  
Good Neurological Outcome ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory

Abstract 81: Early Access to Cardiac Catheterization Laboratory for Patients Resuscitated from Cardiac Arrest Due to a Shockable Rhythm: The Minnesota Resuscitation Consortium Twin Cities Unified Protocol Two-Year Report

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Demetris Yannopoulos ◽  
Santiago Garcia ◽  
Brian Mahoney ◽  
Ralph J Frascone ◽  
Greg Helmer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Real Life ◽  
Inclusion Criteria ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Early Access ◽  
Shockable Rhythm ◽  
Surface Ecg ◽  
Gain Access

Background: Cardiac arrest patients that have been successfully resuscitated from shockable rhythms have a high prevalence of thrombotic and/or flow limiting coronary occlusion regardless of the presence of STEMI on the ECG. In 2012, the Minnesota Resuscitation Consortium (MRC) developed an organized approach for all those patients to gain early access to the cardiac catheterization laboratory (CCL). We report the two-year outcomes. Methods: Eleven metropolitan hospitals with 24/7 PCI capabilities agreed to provide early (within 2 hours of arrival to the emergency department) access to the CCL for all patients that were successfully resuscitated from VF/VT arrest regardless of the presence or absence of STEMI on the surface ECG. Inclusion criteria were: witnessed or un-witnessed, age >18 and <70, cardiac arrest of presumed cardiac etiology, comatose or conscious patients. Patients with PEA or asystole, known DNR/DNI, non-cardiac etiology, significant bleeding of any cause, terminal disease were excluded. Patient outcomes were recorded in the state database Cardiac Arrest Registry to Enhance Survival. Results: A total of 370 patients were resuscitated and met the inclusion criteria. Of those, 313 (85%) patients were taken to the CCL per protocol. The mean age was 55.5 years, 77% were men and 79% had witnessed arrest. Only 57 patients (15%) did not gain access to the CCL. Of the 313 patients that had early coronary angiography a total of 47% received primary angioplasty and had at least one vessel disease and 5% received coronary artery bypass. All comatose patients received therapeutic hypothermia and 35% received and implantable cardiac defibrillator. A total of 235/313 (75%) were discharged alive and of those 222/235 (94.5%) were discharged neurologically intact with a CPC of 1. Of the patients that did not gain access to the CCL, 46% (26/57) were discharged alive and of those 73% (19/26) had CPC of 1 [OR: 3.63; 2.03-6.5, p< 0.001]. Conclusions: Over the first two years of implementation, the MRC protocol for early access to the CCL in resuscitated patients from shockable rhythm was associated with 75% survival to hospital discharge and excellent neurological outcomes in a large metropolitan area and real-life clinical practice.

Cardiac Arrest in the Cardiac Catheterization Laboratory: Initial Experience With the Role of Simulation Setup and Training

2020 ◽  
pp. 106286062095080
Author(s):  
Omar Al-Mukhtar ◽  
Irma Bilgrami ◽  
Samer Noaman ◽  
Rebecca Lapsley ◽  
John Ozcan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Physical Environment ◽  
Improve Patient Care ◽  
Clinical Event ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Percutaneous Coronary ◽  
Specialized Equipment ◽  
Multidisciplinary Simulation

With rising complexity of percutaneous coronary interventions being performed, the incidence of cardiac arrest in the cardiac catheterization laboratory (CCL) is likely to increase. The authors undertook a series of multidisciplinary simulation sessions to identify practice deficiencies and propose solutions to improve patient care. Five simulation sessions were held at Western Health CCL to simulate different cardiac arrest scenarios. Participants included cardiologists, intensivists, anesthetists, nurses, and technicians. Post-simulation feedback was analyzed qualitatively. Challenges encountered were grouped into 4 areas: (1) communication and teamwork, (2) equipment, (3) vascular access and drugs, and (4) physical environment and radiation exposure. Proposed solutions included regular simulation training; increasing familiarity with the physical environment, utilization of specialized equipment; and formation of 2 team leaders to improve efficiency. Cardiac arrest in the CCL is a unique clinical event that necessitates specific training to improve technical and nontechnical skills with potential to improve clinical outcomes.

scholarly journals In-Hospital Cardiac Arrest in the Cardiac Catheterization Laboratory: Effective Transition from an ICU- to CCU-Led Resuscitation Team

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Rajat Sharma ◽  
Hilary Bews ◽  
Hardeep Mahal ◽  
Chantal Y. Asselin ◽  
Megan O’Brien ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Tertiary Care ◽  
Pulseless Electrical Activity ◽  
Hospital Length Of Stay ◽  
Health Concern ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Coronary Syndrome ◽  
Code Blue

Objectives. (1) To examine the incidence and outcomes of in-hospital cardiac arrests (IHCAs) in a large unselected patient population who underwent coronary angiography at a single tertiary academic center and (2) to evaluate a transitional change in which the cardiologist is positioned as the cardiopulmonary resuscitation (CPR) leader in the cardiac catheterization laboratory (CCL) at our local tertiary care institution. Background. IHCA is a major public health concern with increased patient morbidity and mortality. A proportion of all IHCAs occurs in the CCL. Although in-hospital resuscitation teams are often led by an Intensive Care Unit- (ICU-) trained physician and house staff, little is known on the role of a cardiologist in this setting. Methods. Between 2012 and 2016, a single-center retrospective cohort study was performed examining 63 adult patients (70 ± 10 years, 60% males) who suffered from a cardiac arrest in the CCL. The ICU-led IHCAs included 19 patients, and the Coronary Care Unit- (CCU-) led IHCAs included 44 patients. Results. Acute coronary syndrome accounted for more than 50% of cardiac arrests in the CCL. Pulseless electrical activity was the most common rhythm requiring chest compression, and cardiogenic shock most frequently initiated a code blue response. No significant differences were observed between the ICU-led and CCU-led cardiac arrests in terms of hospital length of stay and 1-year survival rate. Conclusion. In the evolving field of Critical Care Cardiology, the transition from an ICU-led to a CCU-lead code blue team in the CCL setting may lead to similar short-term and long-term outcomes.

Abstract 10476: Patient Characteristics and Survival Outcomes of Cardiac Arrest in the Cardiac Catheterization Laboratory: Insights from Get with the Guidelines-Resuscitation Registry

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ahmed Elkaryoni ◽  
John J Lopez ◽  
Paul S Chan
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Odds Ratio ◽  
American Heart ◽  
Patient Characteristics ◽  
Lower Survival Rate ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Get With The Guidelines ◽  
Hospital Cardiac Arrest

Background: The characteristics and outcomes of in-hospital cardiac arrest (IHCA) in the cardiac catheterization laboratory (CCL) have not been well-described. We compared the characteristics and outcomes of patients with an IHCA in the CCL versus those in the operating room (OR) and the intensive care unit (ICU). Methods: Within the American Heart Association’s Get With the Guidelines-Resuscitation® registry, we identified patients 18 years of age or older with an IHCA in the CCL, OR, or ICU between 2000 and 2019. We compared rates of survival to discharge for patients in the CCL, OR, and ICU. Additionally, we examined predictors of survival to discharge for patients with IHCA in the CCL. Results: There were 6866, 5181, and 181,832 patients with an IHCA in the CCL, OR, and ICU, respectively. Patients with IHCAs in the CCL were more likely to have a shockable cardiac arrest rhythm as compared with those in the OR and ICU. Overall, 2614 (38.1%) patients with IHCA in the CCL survived to discharge, as compared with 30,833 (16.9%) from the ICU and 2096 (40.5%) from the OR. After adjustment for 27 patient and cardiac arrest factors, patients with IHCA in CCL were more likely to survive to discharge as compared with those with IHCA from the ICU (odds ratio, 1.37 [95% CI: 1.29-1.46], p<0.001). In contrast, they were less likely to survive to discharge as compared with those with IHCA in the OR (odds ratio, 0.81 [95% CI: 0.69-0.94], p=0.006). Predictors of survival to discharge in patients with IHCA in the CCL included white race, pulseless ventricular tachycardia/fibrillation, and IHCA during normal hours and on weekdays, while having myocardial infarction during this or prior hospitalization was associated with less survival to discharge. (Table). Conclusion: IHCA in the CCL is not uncommon and has a lower survival rate as compared with IHCA in other procedural areas such as the OR. The reasons for this difference deserve further study given that response to IHCAs in both settings should be similar.

Cardiac Arrest in the Cardiac Catheterization Laboratory

2019 ◽  
Vol 12 (18) ◽  
pp. 1840-1849 ◽  
Author(s):  
Kapildeo Lotun ◽  
Huu Tam Truong ◽  
Kyoung-Chul Cha ◽  
Hanan Alsakka ◽  
Renan Gianotto-Oliveira ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Catheterization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory

scholarly journals Neurological Outcome of Chest Compression-Only Bystander CPR in Asphyxial and Non-Asphyxial Out-of-Hospital Cardiac Arrest: An Observational Study

2020 ◽  
Author(s):  
François Javaudin ◽  
Julien Raiffort ◽  
Natacha Desce ◽  
Valentine Baert ◽  
Hervé Hubert ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Adjusted Relative Risk ◽  
Good Neurological Outcome ◽  
Significant Difference ◽  
Bystander Cpr ◽  
Lower Infection ◽  
Hospital Cardiac Arrest

Abstract Background: According to guidelines and bystander skill, two different methods of cardiopulmonary resuscitation (CPR) are feasible: standard CPR (S-CPR) with mouth-to-mouth ventilations and chest compression-only CPR (CO-CPR) without rescue breathing. CO-CPR appears to be most effective for cardiac causes, but there is a lack of evidence for asphyxial causes of out-of-hospital cardiac arrest (OHCA). Thus, the aim of our study was to compare CO-CPR versus S-CPR in adult OHCA from medical etiologies and assess neurologic outcome in asphyxial and non-asphyxial causes.Methods: Using the French National OHCA Registry (RéAC), we performed a multicenter retrospective study over a five-year period (2013 to 2017). All adult-witnessed OHCA who had benefited from either S-CPR or CO-CPR by bystanders were included. Non-medical causes as well as professional rescuers as witnesses were excluded. The primary end point was 30-day neurological outcome in a weighted population for all medical causes, and then for asphyxial, non-asphyxial and cardiac causes. Results: Of the 8 619 subjects included for all medical causes, 6 742 had a non-asphyxial etiology, including 5 904 of cardiac causes, and 1 710 had an asphyxial OHCA. 8.6%; 95% CI [8.1-9.3] of subjects had a good neurological outcome (i.e. cerebral performance category of 1 or 2). Bystanders who performed S-CPR began more often immediately (89.0%; 95% CI [87.3-90.5] versus 78.2%; 95% CI [77.2-79.2]) and in younger subjects (64.1 years versus 65.7; p < 0.001). In the weighted population, subjects receiving bystander-initiated CO-CPR had an adjusted relative risk (aRR) of 1.04; 95% CI [0.79-1.38] of having a good neurological outcome at 30 days for all medical causes, 1.28; 95% CI [0.92-1.77] for asphyxial etiologies, 1.08; 95% CI [0.80-1.46] for non-asphyxial etiologies and 1.09; 95% CI [0.93-1.28] for cardiac-related OHCA.Conclusions: We observed no significant difference in neurological outcome when lay bystanders of OHCA initiated CO-CPR or S-CPR, whether the cause was asphyxial or not. CO-CPR should probably be promoted in adults because it has many advantages (easier to learn and lower infection risk).

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