patients, mean time of CPR was 20.4+21.3 min, 5.8+7.8 adrenalin amp, and 1.63+1.9 atropine amp. The commonest EKG diagnosis on CPR were asystole ...
CLINICAL EPIDEMIOLOGY AND OUTCOMES AFTER CARDIOPULMONARY REANIMATION (CPR) IN ICU IN SOUTH AMERICA. 1
Valencia E. 1Prof. Intensive Care. U de A. CICRET. Medellín, Colombia, South América.
INTRODUCTION. The 2005 AHA Guidelines for CPR and Emergency Cardiovascular Care (ECC) are based on the most comprehensive review of resuscitation literature ever published (1). However, variables related to the sequences of CPR on intensive care patients have been unknown. Recognized patients with risk factors associated to non response after CPR makes possible interventions on the first minutes of CPR. Also, allow to include a chapter of parameter related to CPR on intensive care in the AHA guidelines. Aim: My objective was to analyse the epidemiological and clinical characteristics of CPR on critical ill patients. METHODS. We performed a prospective observational research study from June 2003 to Dec 2004. Forty three patients were analysed. Measurements: Investigated Coagulation variables were: Doses of adrenalin, atropine, vasopressin, ECG diagnosis (VF, VT, pulse less electrical activity, and asystole), and length of CPR. Patients were also classified by researcher such as potential to recover according to base disease (sepsis, ARDS, shock, etc). Statistical analysis: Data (mean and standard deviation, + 2) were performed and chi2 were used to compare mortality and nominal variables. Statistic differences between variables were determined by Mann-Whitney U-test. The statistical analysis was carried out with the SPSS 10 package, and p < 0,05 was considered statistically significant. RESULTS. At once response after CPR was the outcome variable that was studied. Of 43 critically ill patients, mean time of CPR was 20.4+21.3 min, 5.8+7.8 adrenalin amp, and 1.63+1.9 atropine amp. The commonest EKG diagnosis on CPR were asystole 39.5%, VT 23.3%, PEA 11.6%, VF 9.3%, AV block 4.7%. Lidocaine was applied on 5%, vasopressin 10%, Adrenalin 100%, Atropine 40%, and defibrillation 40%. Potential patients to recover were 52.4%, and overall mortality after CPR was 43.4%. Statistics analysis showed no significant correlation between at once response and CPR variables. (Table 1) Variable
Vasopressin (%) Defibrillation (%) Asystole (%) PEA (%) VT (%) FV (%) length of CPR (min.) Adrenaline (Number amp) Atropine (Number amp)
At once response Yes Not 75 25 63.6 36.3 63.6 36.4 80 20 42.9 57.1 100 0 13.2 15.2 12.3 16.8 12.7 16.2
p
0.58 0.95 0.87 0.44 0.14 0.28 0.53 0.15 0.28
CONCLUSION. AHA Guidelines for CPR and ECC deserves a chapter related to CPR on intensive care. Critically ill patients always are under monitoring with arterial line, ECG, and personal more trained on CPR than usual. Therefore, CPR on ICU does not should be ruled out on most recent AHA guidelines due to noncorrelation between CPR variables and immediate response. Outcomes of critically ill patients under CPR may be not depending on only reanimations, also critically ill disease (sepsis, ARDS, trauma, shock, etc) should be taken a count. REFERENCES. 1) Circulation 2005; 112: III-1-III-136.
