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Signa vitae : journal for intesive care and emergency medicine, Vol. 6 No. 1, 2011.

Original scientific paper

Successful resuscitation of out of hospital cardiac arrest patients in the emergency department

Shou-Yen Chen ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
Shih-Hao Wang ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan. nstitute of Environmental and Occupational Health Science, National Yang-Ming University, Taipei, Taiwan
Yi-Ming Weng ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
Yu-Che Chang ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
Yu-Jr Lin ; Biostatistical Center for clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Ko-Chen Chang ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
Jiun-Hao Yu ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan

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Abstract

Background. We examined factors associated with the successful resuscitation, in the emergency department (ED), of adult, out-of-hospital cardiac arrest (OHCA) patients.
Methods. The study cohort consisted of adult patients (over 18 years of age) who presented to the ED in 2009 with a diagnosis of cardiac arrest. Data were retrieved from the institutional database.
Results. A total of 122 adult, non-traumatic, OHCA patients were enrolled in the study. There were no significant differences between the sustained return of spontaneous circulation (ROSC) and non-sustained ROSC groups in initial body temperature (P = 0.420), time to successful intubation (P = 0.524), time to first intravenous epinephrine injection (P = 0.108), blood sugar levels (P = 0.122), hematocrit (P = 0.977), cardiac enzymes (P = 0.116) and serum sodium level (P = 0.429). Leukocytosis (P = 0.047) and cardiac rhythm of pulseless ventricular tachycardia/ ventricular fibrillation and pulseless electrical activity (P = 0.022), were significantly associated with sustained ROSC. In contrast, patients with more severe acidosis (P = 0.003) and hyperkalemia (P < 0.001) had a reduced likelihood of achieving sustained ROSC. After multiple variable logistic regression analysis adjusting for variables, the correlation between sustained ROSC and leukocytosis and hyperkalemia remained high (leukocytosis, P = 0.007, odds ratio [OR] 3.655, 95% CI 1.422-9.395; hyperkalemia, P = 0.001, OR 0.169, 95% CI 0.057-0.500)
Conclusion. Patients suffering an OHCA were appropriately resuscitated after arriving at the ED. Successful resuscitation in adult OHCA victims was determined by the patient's status, in particular their white blood cell count and potassium level.

Keywords

adult out of hospital cardiac arrest; return of spontaneous circulation; in-hospital phase; hyperkalemia; leukocytosis

Hrčak ID:

67509

URI

https://hrcak.srce.hr/67509

Publication date:

1.4.2011.

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