Efficacy of CPR in a general, adult ICU

• Published in: Resuscitation 2003-04, Vol.57 (1), p.43-48
• Main Authors: Myrianthefs, Pavlos, Kalafati, Maria, Lemonidou, Chryssoula, Minasidou, Evegenia, Evagelopoulou, Penelope, Karatzas, Stylianos, Baltopoulos, George
• Format: Article
• Language: English
• Subjects: Adult; Adulto; Adultos; Advanced life support (ALS); Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiac arrest; Cardiopulmonary resuscitation (CPR); Cardiopulmonary Resuscitation - methods; Cardiopulmonary Resuscitation - mortality; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Greece - epidemiology; Heart Arrest - mortality; Heart Arrest - therapy; Hospital Mortality; Hospitals, General; Humans; Intensive care medicine; Intensive care unit (ICU); Intensive Care Units - statistics & numerical data; Male; Medical sciences; Middle Aged; Outcome; Paragem cardı́ aca; Paro cardı́ aco; Reanimación cardiopulmonar (RCP); Reanimação cardiopulmonar (CPR); Resultados; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Soporte vital avanzado (SVA); Suporte avançado de vida (ALS); Survival Analysis; Treatment Outcome; Unidad de cuidados intensivos (UCI); Unidade de cuidados intensivos (ICU)
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/S0300-9572(02)00432-X

Aim: To investigate the initial cardiopulmonary resuscitation (CPR) success rate and long term survival in an Intensive care unit (ICU) population. Patients: All patients with cardiac arrest over a 2-year-period (1999–2000) in a general, adult ICU of a general hospital of Athens. Methods: Retrospective collection of clinical data concerning patients, CPR characteristics and survival rates. Results: We examined 111 ICU patients, aged 56.4±1.9 years (72 males). SAPS II score was 43.9±3.8. CPR was performed in 98.2% of the patients within 30 s. Initial restoration of cardiac function (RCF) and successful CPR rate was 100% while 24 h survival was 9.2%. Survivors at 24 h were younger, mainly males, with lower SAPS II score, mainly with pulmonary disease, ventricular fibrillation or ventricular tachycardia (8/10) and initial pupil reactivity (5/10). Four patients required more than one cycle of CPR. Survival to discharge was zero. Conclusion: Although the initial successful CPR rate in ICU patients may be high, long term survival and hospital discharge is disappointing. Although ICU patients are better monitored and treated in a timely fashion, they are disadvantaged by chronic underlying diseases, severe current medical illnesses and multi organ dysfunction syndrome (MODS) leads to worst outcome after CPR compared with in-ward patients. Objectivo: Investigar a taxa de sucesso da CPR inicial e sobrevivência a longo termo numa população de uma Unidade de Cuidados Intensivos (ICU). Pacientes: Todos os doentes vı́timas de paragem cardı́aca durante um perı́odo de 2 anos (1999–2000) numa ICU polivalente de adultos de um hospital de Atenas. Método: Recolha retrospectiva de dados clı́nicos relativos aos doentes, caracterı́sticas de CPR e taxa de sobrevivência. Resultados: Foram examinados 111 doentes dos ICU, com idade média 56.4±1.9 anos ( 72 homens). O score SAPS II foi de 43.9±3.8. Foi iniciada CPR em 98.2% dos pacientes em 30 s. A Recuperação inicial da Função Cardı́aca (RFC) e a taxa de sucesso da CPR foi de 100%, enquanto que a sobrevivência às 24 horas foi 9.2%. Os sobreviventes às 24 h foram jovens, principalmente homens, com baixos scores de SAPS II, principalmente com doença pulmonar, fibrilhação ventricular ou taquicardia ventricular (8/10) e reactividade pupilar inicial (5/10). Quatro doentes necessitaram de mais de 1 ciclo de CPR. A taxa de sobrevivência à alta foi de zero. Conclusão: Embora a taxa de sucesso inici