Document Detail


Delayed time to defibrillation after intraoperative and periprocedural cardiac arrest.
MedLine Citation:
PMID:  20808215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Delay in defibrillation (more than 2 min) is associated with worse survival in patients with a cardiac arrest because of ventricular fibrillation or pulseless ventricular tachycardia in intensive care units and inpatient wards. METHODS: We tested the relationship between delayed defibrillation and survival from intraoperative or periprocedural cardiac arrest, adjusting for baseline patient characteristics. The analysis was based on data from 865 patients who had intraoperative or periprocedural cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia in 259 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. RESULTS: The median time to defibrillation was less than 1 min (interquartile range, <1 to 1 min). Delays in defibrillation occurred in 119 patients (13.8%). Characteristics associated with delayed defibrillation included pulseless ventricular tachycardia and noncardiac admitting diagnosis. The association between delayed defibrillation and survival to hospital discharge differed for periprocedural and intraoperative cardiac arrests (P value for interaction = 0.003). For patients arresting outside the operating room, delayed defibrillation was associated with a lower probability of surviving to hospital discharge (31.6% vs. 62.1%, adjusted odds ratio 0.49; 95% CI 0.27, 0.88; P = 0.018). In contrast, delayed defibrillation was not associated with survival for cardiac arrests in the operating room (46.8% vs. 39.6%, adjusted odds ratio 1.23, 95% CI 0.70, 2.19, P = 0.47). CONCLUSIONS: Delays in defibrillation occurred in one of seven cardiac arrests in the intraoperative and periprocedural arenas. Although delayed defibrillation was associated with lower rates of survival after cardiac arrests in periprocedural areas, there was no association with survival for cardiac arrests in the operating room.
Authors:
Jill M Mhyre; Satya Krishna Ramachandran; Sachin Kheterpal; Michelle Morris; Paul S Chan;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  113     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2010-10-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  782-93     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, The University of Michigan Health System, Ann Arbor, Michigan, USA. jmmhyre@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Loss, Surgical
Cardiopulmonary Resuscitation*
Cohort Studies
Databases, Factual
Electric Countershock*
Electrocardiography
Female
Heart Arrest / epidemiology,  etiology*,  therapy*
Humans
Intensive Care
Intraoperative Complications / therapy*
Logistic Models
Male
Middle Aged
Monitoring, Intraoperative
Organizational Policy
Perioperative Care
Postoperative Complications / etiology,  therapy
Survival Analysis
Tachycardia, Ventricular / etiology,  therapy
Time Factors
Treatment Outcome
Ventricular Fibrillation / etiology,  therapy
Investigator
Investigator/Affiliation:
Paul S Chan / ; Timothy Mader / ; David J Magid / ; Karl B Kern / ; Sam A Warren / ; Nichol Graham / ; Joseph Ornato / ; Mary Ann Peberdy / ; Romergryko Geocadin / ; R Scott Braithwaite / ; Mary E Mancini / ; Robert A Berg / ; Emilie Allen / ; Elizabeth A Hunt / ; Vinay M Nadkarni / ; Kathy Duncan / ; Tanya Lane Truitt / ; Jerry Potts / ; Brian Eigel /
Comments/Corrections
Comment In:
Anesthesiology. 2010 Oct;113(4):765-6   [PMID:  20808214 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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