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Predictors of electromechanical dissociation during cardiac arrest

1988; Elsevier BV; Volume: 17; Issue: 6 Linguagem: Inglês

10.1016/s0196-0644(88)80394-9

1097-6760

Kim Sutton‐Tyrrell, Norman S. Abramson, Peter Safar, Katherine M. Detre, Sheryl F. Kelsey, Joyce Monroe, O. M. Reinmuth, A. Mullie, Karol Vandevelde, U Hedstrand, Erik Edgren, Harald Breivik, Sven Erik Gisvold, P. Kay Lund, Andreas Skulberg, Dag Tore Fodstad, Tapani Tammisto, P Nikki, Markku Salmenperä, Michael S. Jastremski, B Lind, Per Vaagenes, Marialuisa Bozza-Marrubini, Rinaldo Cantadore, Erga Cerchiari, Dennis Potter, James V. Snyder, Angel Canton, B Kamiński,

Non-Invasive Vital Sign Monitoring

ECG patterns observed during cardiac arrest were analyzed in 261 comatose cardiac arrest survivors. Forty-seven patients (18%) exhibited electromechanical dissociation (EMD) at some point before restoration of stable spontaneous circulation. These patients had a higher mortality (P = .05) and a lower rate of cerebral recovery (P = .01) during the one-year follow-up than study patients who did not exhibit EMD. Patients who developed EMD subsequent to defibrillation had better outcome than patients presenting with EMD. Multivariate analysis revealed that age more than 70 years old (P = .007), pulmonary disease (P < .001), diabetes (P = .013, in-hospital arrests only), and prearrest hypoxemia (P = .013, outside-hospital arrests only) were independently predictive of the occurrence of EMD. Although the generalizability of these findings is limited, they may offer new clues to the pathophysiology of EMD. ECG patterns observed during cardiac arrest were analyzed in 261 comatose cardiac arrest survivors. Forty-seven patients (18%) exhibited electromechanical dissociation (EMD) at some point before restoration of stable spontaneous circulation. These patients had a higher mortality (P = .05) and a lower rate of cerebral recovery (P = .01) during the one-year follow-up than study patients who did not exhibit EMD. Patients who developed EMD subsequent to defibrillation had better outcome than patients presenting with EMD. Multivariate analysis revealed that age more than 70 years old (P = .007), pulmonary disease (P < .001), diabetes (P = .013, in-hospital arrests only), and prearrest hypoxemia (P = .013, outside-hospital arrests only) were independently predictive of the occurrence of EMD. Although the generalizability of these findings is limited, they may offer new clues to the pathophysiology of EMD.