Duration of In-hospital Cardiopulmonary Resuscitation and Its Effect on Survival
Muhammad Arslan Cheema1, Ali R. Ghani1, Waqas Ullah1, Usman Sarwar1, Mary Nagak1, Asoka Balaratna2. 1Internal Medicine, Abington Jefferson Health, Abington, Pennsylvania, United States, 2Cardiology, Abington Jefferson Health, Abington, Pennsylvania, United States
Purpose of Study Pre-hospital cardiopulmonary resuscitation (CPR) efforts are usually beneficial if carried out effectively up to 40 minutes.  However, its impact on in-hospital cardiac arrest and survival remains unknown.  This study aims to determine the correlation between the duration of CPR and the return of spontaneous circulation (ROSC) in an in-hospital cohort.
Methods Used All patients (age ≥ 17 years) receiving CPR at our institution between 2015 and 2017 were included. The primary endpoint was ROSC or death. A total of 88 patients were included in the study. The Pearson correlation of CPR duration with the establishment of ROSC was calculated using the IBM SPSS version 22.
Summary of Results The mean age of included patients was 71.4 years (17-94) which included 72% males and 28% females. In all, 88 patients who received CPR, 55% (n=48) experienced ROSC and survived. The remaining 45% (n=40) of the total, and 56% (n=27) of those with ROSC, died during the same hospitalization.(Figure 1) Among the 48 patients with ROSC, the documented duration of their CPR was about 10 min on average in comparison with 27.5 mins CPR for patients who did not achieve ROSC. (Figure 2) Among all the patients there was a negative correlation between the duration of the CPR and the establishment of ROSC
Conclusions Our study shows that CPR duration is inversely associated with the establishment rates of ROSC. Most of the benefits of CPR can be achieved in the first ten minutes, and a further increase in the duration of CPR provides a minimal gain. Still, the survival can be achievable till 38 mins, and the ideal duration of resuscitation should remain a bedside decision taking into consideration the whole clinical picture.
Figure 1: This figure shows that in those patients in whom ROSC was achieved, 18 patients survived the immediate post ROSC period (0.00), however, 27 patients that achieved ROSC initially died in the immediate post ROSC period (1.00).
Figure 2: This figure shows that the duration of CPR was 27.5 mins in patients who did not achieve ROSC (.00) as compared to just 10 mins in patients in whom ROSC was established (1.00).
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