scholarly journals A Study of the Outcomes and Effective Factors on Cardiopulmonary Resuscitation in an Educational Hospital

2019 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Hossein Aliakbari ◽  
Jalil Azimian ◽  
Fateme Hasandoost ◽  
Maryam Momeni ◽  
Farnoosh Rashvand
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Success Rate ◽  
Night Shift ◽  
Study Success ◽  
Related Factors ◽  
Healthcare Facilities ◽  
Convenience Sampling ◽  
Utstein Style

Background and aims: Cardiopulmonary resuscitation (CPR) success rate is an important issue for all healthcare facilities. In the present study, success rate and related factors were assessed in a hospital in Iran. Methods: This descriptive-correlational study was conducted in 2017. By using the convenience sampling, 156 patients were selected. Variables based on the In-Hospital Utstein-Style were used, which included 3 categories: patients, cardiac arrest and follow-up. Data were analyzed by SPSS 22. Results: Of 156 participants, 92 were male and the average age was 61.4±5.5 years. Most cardiac arrest occurred in night shift (43.6%). The most common cause of cardiac arrest was cancer (33%). Of 156 patients, 102 died. Results showed a significant correlation between success rate, a patient’s sex, rhythm type and medication administered during resuscitation (P<0.001). Conclusion: Success rate in our study was low in comparison to previous studies. Further attention should be paid to this issue.

scholarly journals Impact of the cardiopulmonary resuscitation-related injuries on the prognosis after cardiac arrest

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Merino Argos ◽  
I Marco Clement ◽  
S.O Rosillo Rodriguez ◽  
L Martin Polo ◽  
E Arbas Redondo ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Performance Category ◽  
University Hospital ◽  
Temperature Management ◽  
Performance Category ◽  
Neurological Outcomes ◽  
Cardiac Care Unit ◽  
Sternal Fractures

Abstract Background Cardiopulmonary resuscitation (CPR) manoeuvres involve vigorous compressions with the proper depth and rate in order to keep sufficient perfusion to organs, especially the brain. Accordingly, high incidences of CPR-related injuries (CPR-RI) have been observed in survivors after cardiac arrest (CA). Purpose To analyse whether CPR-related injuries have an impact on the survival and neurological outcomes of comatose survivors after CA. Methods Observational prospective database of consecutive patients (pts) admitted to the acute cardiac care unit of a tertiary university hospital after in-hospital and out-of-hospital CA (IHCA and OHCA) treated with targeted temperature management (TTM 32–34°) from August 2006 to December 2019. CPR-RI were diagnosed by reviewing medical records and analysing image studies during hospitalization. Results A total of 498 pts were included; mean age was 62.7±14.5 years and 393 (78.9%) were men. We found a total of 145 CPR-RI in 109 (21.9%) pts: 79 rib fractures, 20 sternal fractures, 5 hepatic, 5 gastrointestinal, 3 spleen, 1 kidney, 26 lung and 6 heart injuries. Demographic characteristics and cardiovascular risk factors did not differ between the non-CPR-RI group and CPR-RI group. Also, we did not find differences in CA features (Table 1). Survival at discharge was higher in the CPR-RI group [74 (67.8%) vs 188 (48.3%); p&lt;0.001]. Moreover, Cerebral Performance Category (CPC) 1–2 within a 3-month follow-up was significantly higher in the CPR-RI group [(71 (65.1%) vs 168 (43.2%); p&lt;0.001; Figure 1]. Finally, pts who recieved blood transfusions were proportionally higher in the CPR-RI group [34 (32.1%) vs 65 (16.7%)]; p=0.004). Conclusions In our cohort, the presence of CPR-RI was associated with higher survival at discharge and better neurological outcomes during follow-up. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Optimal cardiopulmonary resuscitation duration for favorable neurological outcomes after out-of-hospital cardiac arrest

2022 ◽  
Vol 30 (1) ◽  
Author(s):  
SungJoon Park ◽  
Sung Woo Lee ◽  
Kap Su Han ◽  
Eui Jung Lee ◽  
Dong-Hyun Jang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Patient Characteristics ◽  
Related Factors ◽  
Neurological Outcomes ◽  
Upper Limit ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest ◽  
Off Time

Abstract Background A favorable neurological outcome is closely related to patient characteristics and total cardiopulmonary resuscitation (CPR) duration. The total CPR duration consists of pre-hospital and in-hospital durations. To date, consensus is lacking on the optimal total CPR duration. Therefore, this study aimed to determine the upper limit of total CPR duration, the optimal cut-off time at the pre-hospital level, and the time to switch from conventional CPR to alternative CPR such as extracorporeal CPR. Methods We conducted a retrospective observational study using prospective, multi-center registry of out-of-hospital cardiac arrest (OHCA) patients between October 2015 and June 2019. Emergency medical service–assessed adult patients (aged ≥ 18 years) with non-traumatic OHCA were included. The primary endpoint was a favorable neurological outcome at hospital discharge. Results Among 7914 patients with OHCA, 577 had favorable neurological outcomes. The optimal cut-off for pre-hospital CPR duration in patients with OHCA was 12 min regardless of the initial rhythm. The optimal cut-offs for total CPR duration that transitioned from conventional CPR to an alternative CPR method were 25 and 21 min in patients with initial shockable and non-shockable rhythms, respectively. In the two groups, the upper limits of total CPR duration for achieving a probability of favorable neurological outcomes < 1% were 55–62 and 24–34 min, respectively, while those for a cumulative proportion of favorable neurological outcome > 99% were 43–53 and 45–71 min, respectively. Conclusions Herein, we identified the optimal cut-off time for transitioning from pre-hospital to in-hospital settings and from conventional CPR to alternative resuscitation. Although there is an upper limit of CPR duration, favorable neurological outcomes can be expected according to each patient’s resuscitation-related factors, despite prolonged CPR duration.

scholarly journals Potential effects of angiogenesis-related factors on the severity of APAC and surgical outcomes of trabeculectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Wang ◽  
Ming-shui Fu ◽  
Min-wen Zhou ◽  
Bi-lian Ke ◽  
Zhi-hua Zhang ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Aqueous Humor ◽  
Family Members ◽  
Angle Closure ◽  
Related Factors ◽  
Acute Primary Angle Closure ◽  
Failure Group ◽  
Primary Angle Closure

Abstract Background EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition. The sharp rise of intraocular pressure in acute primary angle closure (APAC) results in an inefficient supply of oxygen and nutrients. We aimed to measure the expression of EPO and PDGF family members in APAC eyes and demonstrate their associations with APAC’s surgical success rate. Methods Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples of 55 patients recruited were measured. Before operations, correlations between target proteins and IOP (intraocular pressure) were detected between APAC (acute primary angle closure) and cataract patients. Based on the post-operative follow-up, the effects of EPO and PDGF family members on the successful rate of trabeculectomy were tested. Results The levels of EPO, PDGF-CC and -DD were significantly elevated in the APAC group compared to the cataract group. During the post-operative follow-up, EPO, PDGF-CC and -DD showed significant differences between the success and failure groups. In multivariable linear regression analyses, failed filtration surgery was more likely in APAC eyes with higher EPO level. The Kaplan-Meier survival plot suggested that the success rate in eyes with low EPO level was significantly higher than that in eyes with high EPO level. Conclusion The levels of EPO, PDGF-CC and -DD were significantly elevated in failure group. EPO level correlated with preoperative IOP and numbers of eyedrops, and higher EPO level in aqueous humor is a risk factor for trabeculectomy failure. It can be a biomarker to estimate the severity of APAC and the success rate of surgery. The investigation of mechanism of EPO in APAC a may have potential clinical applications for the surgical treatment of APAC.

Abstract P193: A Cardiopulmonary Resuscitation Training Program for Family Members of In-Hospital Patients at Risk for Cardiac Arrest

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Marion Leary ◽  
Lori Albright ◽  
Emily B Meshberg ◽  
Noah T Sugerman ◽  
Lance B Becker ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Family Members ◽  
Care Hospital ◽  
Hospital Patients ◽  
Patients At Risk ◽  
Bystander Cpr ◽  
Self Instruction

Background: Resuscitation from cardiac arrest often depends on prompt cardiopulmonary resuscitation (CPR) from the lay public, yet bystander CPR rates in the US are low. One barrier to bystander CPR delivery is that most arrests occur in the home, where only family members may be available to provide care. Little data exist regarding the ability to target and train family members of “at-risk” patients in CPR. Objective: We sought to implement a CPR video self-instruction (VSI) program for family members of in-hospital patients at risk for cardiac arrest. After training in situ before hospital discharge, we tested the hypothesis that at-risk patient family members would be motivated to secondarily train others in the home after leaving the hospital setting. Methods: Family members of patients hospitalized for cardiac conditions at one tertiary-care hospital between 12/07 and 6/08 who met pre-defined inclusion criteria were offered CPR VSI training requiring 25–30 min. All trainees were assessed for skill competence and video recorded for analysis. Trainees were encouraged to take the VSI kit home, and follow-up surveys were conducted to gauge secondary training of other family members. Results: Among 36 enrollees, mean age (SD) was 50 (13) and 78% of trainees were female; only 17% had been CPR trained within the past 10 years, and 44% had never been trained. Most (67%) of the trainees were either children or spouses of the at-risk hospitalized patients. Most (78%) trainees rated their experience with learning CPR via VSI as “comfortable” or “very comfortable”. During 2 min of CPR skills assessment, mean (SD) chest compression rate was 100 (19), mean percentage (SD) adequate depth was 89% (15%), and mean (SD) time for two breaths was 10.8 (4.6) sec. Follow-up surveys revealed that 33% of recipients performed secondary training at home, with a mean (SD) of 1.8 (1.3) secondary trainees. Conclusions: CPR VSI training for family members of hospitalized cardiac patients may serve as a cost-effective model to disseminate resuscitation skills and allows for secondary training in the home of patients at risk for sudden cardiac arrest.

Abstract 13209: Law Enforcement-Initiated Cardiopulmonary Resuscitation in the Care of Out-of-Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Luke A Wohlford ◽  
Bruce J Barnhart ◽  
Daniel W Spaite ◽  
Joshua B Gaither ◽  
Amber D Rice ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Law Enforcement ◽  
Cardiopulmonary Resuscitation ◽  
Patient Care ◽  
Hospital Discharge ◽  
System Response ◽  
Healthcare Facilities ◽  
Bystander Cpr ◽  
Provision Of Care ◽  
Hospital Cardiac Arrest

Background: Little is known about the provision of care by law enforcement (LE) personnel within modern EMS systems. We evaluated LE performance of bystander CPR (BCPR) and associated outcomes in OHCA across Arizona. Methods: A total of 5,654 OHCA cases (1/1/2019-12/31/2019) were evaluated using the Save Hearts in Arizona Registry and Education (SHARE) cardiac arrest registry. Data were abstracted from all EMS patient care records (PCRs). If two parties provided BCPR, the first to give compressions was considered the provider for this analysis. Cases identified as “Stranger” or “Unknown” BCPR were manually evaluated for narrative data to identify BCPR provider when possible. Results: BCPR was provided in 2285 cases [48.8%; (95% CIs 47.4%, 50.3%)] after excluding 850 cases that occurred in healthcare facilities where personnel are duty-bound to provide CPR. LE provided BCPR in 444 patients [19.4% (17.8%, 21.1%)], second only to family/spouse [1143 pts; 50.0% (48.0%, 52.1%)]. Overall, 279 patients survived to hospital discharge [12.2%, (10.9%, 13.6%)]. The Table shows the rates of BCPR in each provider category and the associated rates of survival. Of note is that the rate of bystander AED use was more than four times higher in LE BCPR [6.3% (4.23%, 8.99%)] than family-provided BCPR [1.5% (0.87%, 2.37%; p < 0.0001)], but was still very low. Conclusions: In this statewide study that included more than 130 EMS agencies from frontier to urban settings, LE personnel were frequently involved in the care of OHCA patients within the 911 system response. To our knowledge, this magnitude of provision of BCPR by LE (nearly one in five BCPR cases) has not been reported previously. Furthermore, the consequential rate of LE response to OHCA provides the opportunity to significantly increase AED use. Our findings support the widespread and intentional training of LE in CPR and AED use and has the potential to improve survival in diverse settings.

scholarly journals Cardiopulmonary resuscitation of adults with in-hospital cardiac arrest using the Utstein style

2016 ◽  
Vol 28 (4) ◽  
Author(s):  
Rose Mary Ferreira Lisboa da Silva ◽  
Bruna Adriene Gomes de Lima e Silva ◽  
Fábio Junior Modesto e Silva ◽  
Carlos Faria Santos Amaral
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Utstein Style ◽  
Hospital Cardiac Arrest

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.

Out-of-hospital cardiac arrest (OHCA) and cardiopulmonary resuscitation in Thessaloniki, Greece, an Utstein style analysis

Resuscitation ◽  
2010 ◽  
Vol 81 (2) ◽  
pp. S7 ◽  
Author(s):  
V. Grosomanidis ◽  
B. Fyntanidou ◽  
K. Fortounis ◽  
D. Ekklisiarchos ◽  
A. Amaniti ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Style Analysis ◽  
Utstein Style ◽  
Hospital Cardiac Arrest
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