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Outcome of cardiopulmonary resuscitation following open heart surgery
A Wahba1, W Götz, D E Birnbaum
1Clinic of Cardiothoracic Surgery, University of Regensburg, Germany.
Insights
Cardiopulmonary resuscitation (CPR) after heart surgery is uncommon but carries a high mortality rate. However, aggressive treatment, including emergency rethoracotomy, can lead to long-term survival in about half of patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Critical Care Medicine
Background:
- The outcomes of cardiopulmonary resuscitation (CPR) following cardiac surgery are not well-established.
- Cardiac surgery patients may require CPR due to various complications.
Purpose of the Study:
- To analyze the outcomes of patients who underwent CPR after cardiac surgery.
- To identify factors influencing survival and mortality in this patient group.
Main Methods:
- Retrospective analysis of patients requiring CPR during their hospital stay post-cardiac surgery.
- Data collected included CPR duration, interventions (emergency rethoracotomy, coronary artery bypass grafting), causes of death, and long-term survival status.
Main Results:
- 1.4% of patients required CPR, with a mean duration of 42 minutes.
- Hospital mortality was 46%, significantly correlated with CPR duration (r = 0.44, p = 0.004).
- Common causes of death included multiorgan failure; 50% of patients receiving aggressive treatment achieved long-term survival without neurological sequelae.
Conclusions:
- Ventricular fibrillation and myocardial ischemia are primary indications for CPR post-cardiac surgery.
- Aggressive management, including emergency rethoracotomy, improves long-term survival rates.
- CPR following cardiac surgery necessitates careful consideration of prognosis and treatment strategies.
Abstract:
The outcome of cardiopulmonary resuscitation (CPR) following cardiac surgery is not known to date. A retrospective analysis of all patients subjected to CPR during their hospital stay following heart surgery was conducted; 1.4% of patients required CPR 0.5-192 h following surgery. The mean duration of CPR was 42 +/- 29 min. Twenty-nine patients were subjected to emergency rethoractomy and 14 patients received coronary artery bypass grafting. The hospital mortality was 46%. There was a significant correlation of duration of CPR and death (r = 0.44, p = 0.004). The commonest cause of death was consecutive multiorgan failure in 12 patients. Twenty-one patients were long-term survivors without neurological sequelae. Twenty patients were in NYHA class I or II. Ventricular fibrillation and myocardial ischaemia are the commonest conditions leading to CPR in an average population of patients immediately after cardiac surgery. Aggressive treatment and emergency rethoracotomy in most cases results in long-term survival in 50%.