| Delayed time to defibrillation after intraoperative and periprocedural cardiac arrest. | |
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MedLine Citation:
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PMID: 20808215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jill M Mhyre; Satya Krishna Ramachandran; Sachin Kheterpal; Michelle Morris; Paul S Chan; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 113 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-24 Completed Date: 2010-10-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 782-93 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, The University of Michigan Health System, Ann Arbor, Michigan, USA. jmmhyre@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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Anesthesiology. 2010 Oct;113(4):765-6
[PMID:
20808214
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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