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In-hospital cardiac arrest: the state of the art

James Penketh1, Jerry P Nolan2,3

  • 1Intensive Care Unit, Royal United Hospital, Bath, UK. jpenketh@nhs.net.

Critical Care (London, England)
|December 6, 2022
PubMed

Insights

Mortality from in-hospital cardiac arrest (IHCA) is decreasing due to rapid response teams and better defibrillator access. Airway management trends shift towards supraglottic devices, with prognostication challenges remaining.

Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Emergency Medicine

Background:

  • In-hospital cardiac arrest (IHCA) carries a high mortality risk, though rates are declining.
  • Epidemiological data and registries are crucial for understanding IHCA trends.
  • Advancements in rapid response teams and defibrillator technology are impacting outcomes.

Purpose of the Study:

  • To review current trends and understanding of in-hospital cardiac arrest (IHCA).
  • To discuss evolving airway management strategies and prognostication challenges.
  • To highlight the role of advanced care planning in IHCA management.

Main Methods:

  • Review of epidemiological data from cardiac arrest registries.
  • Analysis of trends in rapid response team implementation and technology adoption.
  • Examination of studies on airway management and pre-arrest factors.

Main Results:

  • Hospital mortality rates for IHCA are decreasing.
  • There is a trend towards decreased tracheal intubation and increased supraglottic airway device use.
  • Pre-arrest factors influence outcomes, but prognostication remains challenging due to study bias.

Conclusions:

  • Decreasing IHCA mortality is linked to rapid response teams and improved technology.
  • Optimal airway management is evolving, with ongoing research into supraglottic devices.
  • Shared decision-making and advanced care planning are vital for appropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions.

Keywords:
Cardiac arrestPrognosticationResponseResuscitationTreatment

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