Antecedents to cardiac arrests in a teaching hospital intensive care unit.

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  • Additional Information
    • Source:
      Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
    • Publication Information:
      Publication: Limerick : Elsevier/north-Holland Biomedical Press
      Original Publication: London, Middlesex Pub. Co.
    • Subject Terms:
      Prodromal Symptoms*; Heart Arrest/*diagnosis; Aged ; Case-Control Studies ; Female ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies
    • 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.
      Objectives: To study the antecedents to, and characteristics of CAs in ICU.
      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.
      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 (22 breaths/min vs. 18 breaths/min, p=0.001) and minimum respiratory rates (16 breaths/min vs. 12 breaths/min, p=0.031), a lower median mean arterial pressure (65 mmHg vs. 70 mmHg, p=0.029) and systolic blood pressure (97 mmHg vs. 106 mmHg, p=0.033), a higher central venous pressure (14 cm H2O vs. 11 cm H2O, p=0.008) and a lower bicarbonate level (20.5 mmol vs. 26 mmol, p=0.018) compared to controls. CA patients also had a higher maximum dose of noradrenaline (norepinephrine) (17.5 mcg/min vs. 8.0 mcg/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 48 h 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.
      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%.
      (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Advanced life support (ALS); Antecedents; Cardiac arrest; Cardiopulmonary resuscitation (CPR); Epidemiology; Intensive care
    • Publication Date:
      Date Created: 20131212 Date Completed: 20141222 Latest Revision: 20140221
    • Publication Date:
      20210210
    • Accession Number:
      10.1016/j.resuscitation.2013.11.018
    • Accession Number:
      24326274
  • 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=mdc&AN=24326274. Acesso em: 14 abr. 2021.
    • AMA 11th Edition:
      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 7th Edition:
      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 17th Edition:
      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 14 April 2021, .
    • MLA 8th Edition:
      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 17th Edition:
      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 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 [cited 2021 Apr 14];85(3):411–7. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=24326274