Portal de Periódicos da CAPES

In‐hospital cardiopulmonary resuscitation

1999; Wiley; Volume: 43; Issue: 2 Linguagem: Inglês

10.1034/j.1399-6576.1999.430210.x

1399-6576

Eirik Skogvoll, Erik Ramon Isern, G. K. Sangolt, Sven Erik Gisvold,

Respiratory Support and Mechanisms

Background: Direct comparison of survival rates from in‐hospital cardiopulmonary resuscitation (CPR) remains difficult. The objective of this study was to report outcome according to the Utstein template for in‐hospital cardiac arrest and to evaluate the Utstein template itself as applied to a retrospective material. Methods: The hospital (900 beds, 37 000 annual admissions) has no established do‐not‐resuscitate (DNR) order policy. CPR outside the Intensive‐ or Coronary Care Units (ICU/CCU) is performed by an emergency medical team consisting of an anaesthesiologist, a medical resident and a nurse anaesthetist. CPR attempts during 5 years (1990–1994) were analysed retrospectively. Patient survival, cerebral and overall performance category (CPC/OPC) score of the survivors was determined. The Utstein template was evaluated in terms of clinical relevance and data availability. Results: During 5 years, 4927 patients died as in‐patients. CPR outside the CCU/ICU was attempted 244 times. CPR was primarily successful on 83 occasions (34%), and 42 patients (17%) were finally discharged with CPC 1 or 2. Survival from primary ventricular fibrillation (VF) or ventricular tachycardia was 40%, pulseless electrical activity 3%, asystole 11% and of rhythm undetermined 6%. Age or sex effects were not observed. Conclusion: More than 90% of in‐hospital deaths in this hospital are handled without CPR being initiated. Overall survival was 17%, and almost all survivors made a favourable outcome. The Utstein template for in‐hospital cardiac arrest performed acceptably as a framework for reporting outcome in this retrospective study.