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Bias was minimised by following the PRISMA procedure with minimal deviation. This hypothesis
could explain their apparently conflicting results in which average CPC score correlates with CPR
time, but percentage of good outcomes does not. Search methods A search of Cinahl, Medline,
PubMed, Scopus and Web of Science was conducted in March 2016. Global incidences of out-of-
hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. OHCA and
the successful outcome of cardiac arrest survival is depending. They also reported that arrests
witnessed by medical staff had a significantly better neurological outcome. Studies looking at
additional interventions such as extracorporeal resuscitation and therapeutic hypothermia were not
included. One of these studied IHCA and had an average of 6 minutes of CPR for a good outcome
compared to 15 minutes for a poor outcome. The author states that several potential ethical problems
arise in relation to DNR (do not perform CPR) orders. Quality appraisal findings The papers were
given quality scores ranging from eight to 11 out of 12 (Table 5 ), using the appraisal process
described. Results Search outcomes Following a systematic literature search in five databases, 2137
studies were found in total, with an additional 23 studies found from hand searching. Five of the
studies used Cerebral Performance Category (CPC) and two used the modified Rankin Scale (mRS)
to measure neurological outcome. Considering the damaging effects of CPR, the difficult decision
about when to terminate resuscitation attempts in those with no ROSC must be made by healthcare
professionals. This review seeks to explore whether the risk of brain damage increases with
prolonged CPR in the hospital setting. Brain damage can seriously impact the lives of survivors of
CPR sometimes causing permanent disability. Cardiac arrest: the science and practice of resuscitation
medicine. As with any systematic review, there is a risk of publication bias as many papers will only
report significant findings. There is no evidence to justify the assumption that this should improve
the validity of the studies’ findings. Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society
of Cardiology 2017. This was one of the highest quality studies and had a very large, representative
study population. Review and Outcome of Prolonged Cardiopulmonary Resuscitation. The only
exception to this was in one study which found this only to be the case in OHCA. Post-cardiac arrest
syndrome: Epidemiology, pathophysiology, treatment, and prognostication: A Scientific Statement
from the International Liaison Committee on Resuscitation; the American Heart Association
Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia;
the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical
Cardiology; the Council on Stroke. The Creative Commons Public Domain Dedication waiver ( )
applies to the data made available in this article, unless otherwise stated. The limited similarity
between studies prevented conducting a meta-analysis. Duration of resuscitation efforts and
functional outcome after out-of-hospital cardiac arrest when should we change to novel therapies.
Resusitasi Kardiopulmonari (CPR) adalah prosedur kecemasan yang dilakukan. Global presence
refers to the act of well-established firms' risking getting into foreign business environments and
decides to take an international approach to business. Therapies supplementary to advanced life
support such as extracorporeal resuscitation or therapeutic hypothermia were excluded from the
review. CPR should be started before the rhythm is identified and should be.
These were appraised for quality and were mostly of a high standard. Upload Read for free FAQ and
support Language (EN) Sign in Skip carousel Carousel Previous Carousel Next What is Scribd. In
addition, reference lists of relevant papers and the journals Resuscitation and Circulation, which are
the European Resuscitation Council and AHA’s journals respectively, were hand searched. All of the
papers were cohort studies and generally used data collected routinely through national or hospital
registries. The contents of a crash cart vary from hospital to hospital, but typically. Clinicians should
continue to take into account that in many cases the chance of neurologically favourable survival
decreases the longer CPR is continued, however this alone is not enough to make the decision to
terminate efforts. If the patient is likely to have a good outcome then prolonged CPR is justifiable,
whereas in those cases where the arrest is likely to have a poor outcome this may worsen with
prolonged CPR. The study period was from January 2010 to March 2016. If they appeared relevant,
the full-text articles were assessed for eligibility (Fig. 1 ). The literature search period was from
January 2010 to March 2016. Search carried out in Cinahl (EbscoHost) (DOCX 19 kb) Rights and
permissions. Director, Emergency Medicine, Aster DM Healthcare,India. However, little research has
been done to investigate the link between initial rhythm and neurological outcome with prolonged
CPR. Cardiac arrest followed by CPR and subsequent return of spontaneous circulation (ROSC)
leads to global ischaemia-reperfusion injury. DIAGNOSTIC TESTS for neurological patients.pptx 2.
DIAGNOSTIC TESTS for neurological patients.pptx Cardio pulmonary resuscitation 1. 1. You can
download the paper by clicking the button above. Global presence refers to the act of well-
established firms' risking getting into foreign business environments and decides to take an
international approach to business. OHCA and the successful outcome of cardiac arrest survival is
depending. This may be an indicator of the importance of cause of arrest in likelihood of survival
with a good outcome. Summary: 2015 American Heart Association Guidelines Update for. The
findings are generalisable to the study population, as both IHCA and OHCA in most hospital
settings, all arrest types and a wide variety of hospitals and locations were included. Quality
appraisal findings The papers were given quality scores ranging from eight to 11 out of 12 (Table 5 ),
using the appraisal process described. Other demographics such as ethnicity were not usually
included. This risk must be considered when making decisions about terminating resuscitation.
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Conclusions Current guidelines
on terminating in-hospital resuscitation are discussed very briefly, leaving healthcare professionals to
use clinical judgement as the main factor when making these decisions. These are very damaging and
react with many macromolecules, including DNA, proteins and lipids. Factors influencing outcomes
after cardiopulmonary resuscitation in emergency department. Download Free PDF View PDF
European Resuscitation Council Guidelines for Resuscitation 2015 Section 2. In serious cases this
can lead to permanent disability. As with any systematic review, there is a risk of publication bias as
many papers will only report significant findings.
We use cookies to create the best experience for you. It is unclear why some survivors of prolonged
resuscitation had complete neurological recovery whilst others did not and further research focusing
on duration of CPR, neurological outcome and the factors that affect these may help to answer this.
This review has highlighted many gaps in the knowledge where future research is needed; a validated
and reliable measure of neurological outcome following cardiac arrest, more focused research on the
effects of duration on neurological outcome and further research into the factors leading to brain
damage in cardiac arrest. There was insufficient evidence to determine a meaningful difference
between OHCA and IHCA. Both of these findings are consistent with greater likelihood that time
between arrest and commencement of CPR was relatively short. Determinants of quality of life in
survivors of cardiac arrest. If this interpretation is correct, it has important implications. All
parameters in the chosen appraisal tool were equally weighted despite the possibility of some having
greater influence in the overall quality than others. Do pulse and Rhythm check in every 2 minutes
or after 5 cycles of CPR. CPR should be performed immediately on any person who has become.
Shockable rhythm was a significant predictor of favourable outcome. However, Inter- observer and
intra-observer variation in handling of the assessment tool is likely to occur in real-life setting which
could also produce a bias in the results. The duration of cardiopulmonary resuscitation in emergency
departments after out-of-hospital cardiac arrest is associated with the outcome: A nationwide
observational study. If the patient is likely to have a good outcome then prolonged CPR is
justifiable, whereas in those cases where the arrest is likely to have a poor outcome this may worsen
with prolonged CPR. Measuring outcome after cardiac arrest: construct validity of Cerebral
Performance Category. This review seeks to explore whether the risk of brain damage increases with
prolonged CPR in the hospital setting. It is unclear whether ischaemic-reperfusion damage is the
direct cause, due to the life-changing impact any critical illness may have. Creation of the search
string was overseen by a subject specific librarian. Quality appraisal findings The papers were given
quality scores ranging from eight to 11 out of 12 (Table 5 ), using the appraisal process described. It
may be that the increased period of hypoxia whilst no CPR is being carried out leads to brain
damage further exacerbated by reperfusion injury. CPR involves chest compressions at least 5 cm
deep and at a. Fig 10 - mouth to mouth breathing using a face shield. Four of the studies were
conducted at a single site and three were multicentre, with the majority conducted in Europe and the
US. An alternative may have been to use a scale however this may be more subjective. The risk of
missing potentially relevant articles when searching was minimised by searching five different
databases and hand searching relevant journals and reference lists. There is a definite need to assess
weather the procedure delivered by health care personnel is in compliance with international
published guidelines. Part 3: ethical issues: 2015 American Heart Association guidelines update for
cardiopulmonary resuscitation and emergency cardiovascular care. Public access defibrillation
programmes have led to higher rates of surv. Duration of resuscitation efforts and survival after in-
hospital cardiac arrest: an observational study. Due to the heterogeneity of data interpretation,
analyses and reported outcomes, it was not possible to determine a time beyond which resuscitation
would be unlikely to yield a favourable outcome.
NE made substantial contributions to the design of the review and critically revising the manuscript.
The only absolute contraindication to CPR is a do-not-resuscitate (DNR). Data extraction was
completed by one author (CW) and overread by the second author (NE). Let us write or edit the
literature review on your topic. If the patient is likely to have a good outcome then prolonged CPR is
justifiable, whereas in those cases where the arrest is likely to have a poor outcome this may worsen
with prolonged CPR. Cognitive impairment in survivors of out-of-hospital cardiac arrest. Fig 10 -
mouth to mouth breathing using a face shield. Case studies, which often report remarkable outcomes,
were excluded from this review due to the risk of publication bias however their findings can be
interesting and useful. The abrupt cessation of blood flow causes ischaemia and hypoxia. Defibrillate
as soon as possible in all cases of shockable rhythm. AED. Part 3: ethical issues: 2015 American
Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular
care. In its full, standard form, CPR comprises the following 3 steps, performed in. However, little
research has been done to investigate the link between initial rhythm and neurological outcome with
prolonged CPR. The two studies including only OHCA both found a significant link between
duration and neurological outcome. Most of the studies confirmed that more favourable outcomes
were associated with shorter duration of CPR. It is therefore important to better understand other
arrest factors which have an impact on outcome. Potentially relevant articles were then screened
based on title and then on reading the abstract. These are very damaging and react with many
macromolecules, including DNA, proteins and lipids. Summary: 2015 American Heart Association
Guidelines Update for. AED on and follow the audio instructions when prompted. European
Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Despite the similarities in data
collection between the studies, there was considerable variation in data interpretation and
presentation of results. Five databases were searched in addition to hand searching the journals
Resuscitation and Circulation and reference lists, quality of the selected studies was assessed and a
narrative summary of the data presented. All cases of sudden collapses are cardiac arrest unless
otherwise. Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology 2017. The
aim of this review was to explore the effects of duration of cardiopulmonary resuscitation on
neurological outcome in survivors of both in-hospital and out-of-hospital cardiac arrest achieving
return of spontaneous circulation in hospital. They also reported that arrests witnessed by medical
staff had a significantly better neurological outcome. Measuring outcome after cardiac arrest:
construct validity of Cerebral Performance Category. Upload Read for free FAQ and support
Language (EN) Sign in Skip carousel Carousel Previous Carousel Next What is Scribd. Although
there has always been a lot of emphasis on the spontaneity, available resources and the delivery of
adequate medical care to patients who present with cardiac arrest, not much has been said and done
about the “quality” of CPR administered to these patients in a hospital settings which is undoubtedly
the primary factor affecting survival outcome.
Benjamin et al (2005) conducted a study in this respect and measured the chest compression rates
during CPR in three hospital settings using a validated handheld recording device that provided
readily quantifiable metric (chest compression rate) as a surrogate measure for CPR quality. The
psychosocial outcomes of anoxic brain injury following cardiac arrest. Part 3: ethical issues: 2015
American Heart Association guidelines update for cardiopulmonary resuscitation and emergency
cardiovascular care. AED on and follow the audio instructions when prompted. To perform the
BVM or invasive airway technique, the provider does the. Results Search outcomes Following a
systematic literature search in five databases, 2137 studies were found in total, with an additional 23
studies found from hand searching. Brain injury is always a risk in cardiac arrest patients achieving
ROSC, however it is possible that prolonged CPR may cause further damage due to reduced cardiac
output during resuscitation. Data extraction was completed by one author (CW) and overread by the
second author (NE). Assessment of cardiac electrical activity via rapid “rhythm strip” recording.
Cognitive impairment in survivors of out-of-hospital cardiac arrest. The Creative Commons Public
Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise
stated. Review and Outcome of Prolonged Cardiopulmonary Resuscitation. Other demographics
such as ethnicity were not usually included. The aims of this systematic review were therefore to
explore the effects of duration of CPR on neurological outcome in survivors of both in-hospital
cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) achieving ROSC in hospital and to
investigate whether there is a maximum duration of CPR to avoid or reduce the risk of unfavourable
outcome. Report this Document Save Save Prone cardiopulmonary resuscitation: A scoping and. One
of these studied IHCA and had an average of 6 minutes of CPR for a good outcome compared to 15
minutes for a poor outcome. It is hoped that in the future, enough conclusive evidence from quality
research will lead to provision of clearer guidance on terminating resuscitation in the hospital setting.
Age, sex, and hospital factors are associated with the duration of cardiopulmonary resuscitation in
hospitalized patients who do not experience sustained return of spontaneous circulation. Quality
assessment tool for observational cohort and cross-sectional studies. 2014. Available at:. Accessed 18
Feb 2016. Let us write or edit the literature review on your topic. Global incidences of out-of-
hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. This may have
affected the quality of our findings which would have been more reliable had there been a
standardised measure for neurological outcome implemented across clinical practice. Keep on
browsing if you are OK with that, or find out how to manage cookies. Different Types of Heart
Surgery Offered at Gokuldas Hospital Exploring Treat. Kouwenhovens method of closed-chest
cardiac compression improved the outcome of cardiopulmonary resuscitation (CPR) dramatically.
There is a definite need to assess weather the procedure delivered by health care personnel is in
compliance with international published guidelines. Defibrillation is a process in which an electronic
device gives an electrical. Both of these findings are consistent with greater likelihood that time
between arrest and commencement of CPR was relatively short. The study period was from January
2010 to March 2016. Since the searches were conducted there has been additional research published
which would have met the inclusion criteria for this study.