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Antecedents to cardiac arrests in a teaching hospital intensive care unit

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  • Additional Information
    • Affiliation:
      a Alfred Hospital, Commercial Road, Melbourne, Australia
      b Austin Hospital, Australia
    • Note:
      A Spanish translated version of the summary of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2013.11.018.
    • Keywords:
      Antecedents
      Epidemiology
      Intensive care
      Cardiac arrest
      Advanced life support (ALS)
      Cardiopulmonary resuscitation (CPR)
    • Abstract:
      Background In hospital cardiac arrests (CA) treated with cardio-pulmonary resuscitation (CPR) outside of the intensive care unit (ICU) have poor outcomes. Most are preceded by deranged vital signs. There are, however, limited studies assessing antecedents to CAs inside the ICU.
    • Abstract:
      Study population We prospectively identified CA cases that occurred inside our ICU between January 2010 and July 2012. Controls were obtained by sequentially matching ICU patients based on APACHE III diagnosis, APACHE III score, age, gender and length of stay in ICU.
    • Abstract:
      Results Thirty-six patients had a CA during the study period (6.28/1000 admissions). In the 12h prior to CA, index patients had higher maximum (22breaths/min vs. 18breaths/min, p=0.001) and minimum respiratory rates (16breaths/min vs. 12breaths/min, p=0.031), a lower median mean arterial pressure (65mmHg vs. 70mmHg, p=0.029) and systolic blood pressure (97mmHg vs. 106mmHg, p=0.033), a higher central venous pressure (14cm H2O vs. 11cm H2O, p=0.008) and a lower bicarbonate level (20.5mmol vs. 26mmol, p=0.018) compared to controls. CA patients also had a higher maximum dose of noradrenaline (norepinephrine) (17.5mcg/min vs. 8.0mcg/min, p=0.052) but there was no difference in any other levels of intensive care support. Two-thirds of CA's occurred within the first 48h of ICU admission. The initial monitored rhythm was non-shock responsive (pulseless electrical activity, bradycardia or asystole) in 26/36 (72%). Return of spontaneous circulation was achieved in 29/36 (80.6%) patients, with 16/36 (44.4%) surviving to hospital discharge.
    • Abstract:
      Conclusions In the period leading up to the CA inside ICU, there were signs of physiological instability and the need for higher doses of noradrenaline. Return of spontaneous circulation was achieved in 80%. However, in-hospital mortality was greater than 50%.
    • ISSN:
      0300-9572
    • Accession Number:
      10.1016/j.resuscitation.2013.11.018
    • Accession Number:
      S0300957213008812
    • Copyright:
      Copyright © 2013 Elsevier Ireland Ltd All rights reserved.
  • Citations
    • ABNT:
      ROZEN, T. H. et al. Antecedents to cardiac arrests in a teaching hospital intensive care unit. Resuscitation, [s. l.], v. 85, n. 3, p. 411–417, 2014. DOI 10.1016/j.resuscitation.2013.11.018. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0300957213008812. Acesso em: 28 out. 2020.
    • AMA:
      Rozen TH, Mullane S, Kaufman M, et al. Antecedents to cardiac arrests in a teaching hospital intensive care unit. Resuscitation. 2014;85(3):411-417. doi:10.1016/j.resuscitation.2013.11.018
    • APA:
      Rozen, T. H., Mullane, S., Kaufman, M., Hsiao, Y.-F. F., Warrillow, S., Bellomo, R., & Jones, D. A. (2014). Antecedents to cardiac arrests in a teaching hospital intensive care unit. Resuscitation, 85(3), 411–417. https://doi.org/10.1016/j.resuscitation.2013.11.018
    • Chicago/Turabian: Author-Date:
      Rozen, Thomas H., Siobhan Mullane, Melissa Kaufman, Yu-Feng Frank Hsiao, Stephen Warrillow, Rinaldo Bellomo, and Daryl A. Jones. 2014. “Antecedents to Cardiac Arrests in a Teaching Hospital Intensive Care Unit.” Resuscitation 85 (3): 411–17. doi:10.1016/j.resuscitation.2013.11.018.
    • Harvard:
      Rozen, T. H. et al. (2014) ‘Antecedents to cardiac arrests in a teaching hospital intensive care unit’, Resuscitation, 85(3), pp. 411–417. doi: 10.1016/j.resuscitation.2013.11.018.
    • Harvard: Australian:
      Rozen, TH, Mullane, S, Kaufman, M, Hsiao, Y-FF, Warrillow, S, Bellomo, R & Jones, DA 2014, ‘Antecedents to cardiac arrests in a teaching hospital intensive care unit’, Resuscitation, vol. 85, no. 3, pp. 411–417, viewed 28 October 2020, .
    • MLA:
      Rozen, Thomas H., et al. “Antecedents to Cardiac Arrests in a Teaching Hospital Intensive Care Unit.” Resuscitation, vol. 85, no. 3, Mar. 2014, pp. 411–417. EBSCOhost, doi:10.1016/j.resuscitation.2013.11.018.
    • Chicago/Turabian: Humanities:
      Rozen, Thomas H., Siobhan Mullane, Melissa Kaufman, Yu-Feng Frank Hsiao, Stephen Warrillow, Rinaldo Bellomo, and Daryl A. Jones. “Antecedents to Cardiac Arrests in a Teaching Hospital Intensive Care Unit.” Resuscitation 85, no. 3 (March 1, 2014): 411–17. doi:10.1016/j.resuscitation.2013.11.018.
    • Vancouver/ICMJE:
      Rozen TH, Mullane S, Kaufman M, Hsiao Y-FF, Warrillow S, Bellomo R, et al. Antecedents to cardiac arrests in a teaching hospital intensive care unit. Resuscitation [Internet]. 2014 Mar 1 [cited 2020 Oct 28];85(3):411–7. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0300957213008812