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Efficacy of CPR in a general, adult ICU
Pavlos Myrianthefs1, Maria Kalafati, Chryssoula Lemonidou
1Athens University School of Nursing ICU at 'KAT' General Hospital, Nikis 2, Kifissia, 14561, Athens, Greece. p-myrianthefs@northwestern.edu
Aim:
To investigate the initial cardiopulmonary resuscitation (CPR) success rate and long term survival in an Intensive care unit (ICU) population.
Patients:
All patients with cardiac arrest over a 2-year-period (1999-2000) in a general, adult ICU of a general hospital of Athens.
Methods:
Retrospective collection of clinical data concerning patients, CPR characteristics and survival rates.
Results:
We examined 111 ICU patients, aged 56.4+/-1.9 years (72 males). SAPS II score was 43.9+/-3.8. CPR was performed in 98.2% of the patients within 30 s. Initial restoration of cardiac function (RCF) and successful CPR rate was 100% while 24 h survival was 9.2%. Survivors at 24 h were younger, mainly males, with lower SAPS II score, mainly with pulmonary disease, ventricular fibrillation or ventricular tachycardia (8/10) and initial pupil reactivity (5/10). Four patients required more than one cycle of CPR. Survival to discharge was zero.
Conclusion:
Although the initial successful CPR rate in ICU patients may be high, long term survival and hospital discharge is disappointing. Although ICU patients are better monitored and treated in a timely fashion, they are disadvantaged by chronic underlying diseases, severe current medical illnesses and multi organ dysfunction syndrome (MODS) leads to worst outcome after CPR compared with in-ward patients.