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Comparison of two strategies for managing in-hospital cardiac arrest

In-hospital cardiac arrest (IHCA) is associated with poor outcomes. There are currently no standards for cardiac arrest teams in terms of member composition and task allocation. Here we aimed to compare two different cardiac arrest team concepts to cover IHCA management in terms of survival and neur...

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Detalles Bibliográficos
Autores principales: Haschemi, Jafer, Erkens, Ralf, Orzech, Robert, Haurand, Jean Marc, Jung, Christian, Kelm, Malte, Westenfeld, Ralf, Horn, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602649/
https://www.ncbi.nlm.nih.gov/pubmed/34795366
http://dx.doi.org/10.1038/s41598-021-02027-2
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author Haschemi, Jafer
Erkens, Ralf
Orzech, Robert
Haurand, Jean Marc
Jung, Christian
Kelm, Malte
Westenfeld, Ralf
Horn, Patrick
author_facet Haschemi, Jafer
Erkens, Ralf
Orzech, Robert
Haurand, Jean Marc
Jung, Christian
Kelm, Malte
Westenfeld, Ralf
Horn, Patrick
author_sort Haschemi, Jafer
collection PubMed
description In-hospital cardiac arrest (IHCA) is associated with poor outcomes. There are currently no standards for cardiac arrest teams in terms of member composition and task allocation. Here we aimed to compare two different cardiac arrest team concepts to cover IHCA management in terms of survival and neurological outcomes. This prospective study enrolled 412 patients with IHCA from general medical wards. From May 2014 to April 2016, 228 patients were directly transferred to the intensive care unit (ICU) for ongoing resuscitation. In the ICU, resuscitation was extended to advanced cardiac life support (ACLS) (Load-and-Go [LaG] group). By May 2016, a dedicated cardiac arrest team provided by the ICU provided ACLS in the ward. After return of spontaneous circulation (ROSC), the patients (n = 184) were transferred to the ICU (Stay-and-Treat [SaT] group). Overall, baseline characteristics, aetiologies, and characteristics of cardiac arrest were similar between groups. The time to endotracheal intubation was longer in the LaG group than in the SaT group (6 [5, 8] min versus 4 [2, 5] min, p = 0.001). In the LaG group, 96% of the patients were transferred to the ICU regardless of ROSC achievement. In the SaT group, 83% of patients were transferred to the ICU (p = 0.001). Survival to discharge did not differ between the LaG (33%) and the SaT (35%) groups (p = 0.758). Ultimately, 22% of patients in the LaG group versus 21% in the SaT group were discharged with good neurological outcomes (p = 0.857). In conclusion, we demonstrated that the cardiac arrest team concepts for the management of IHCA did not differ in terms of survival and neurological outcomes. However, a dedicated (intensive care) cardiac arrest team could take some load off the ICU.
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spelling pubmed-86026492021-11-22 Comparison of two strategies for managing in-hospital cardiac arrest Haschemi, Jafer Erkens, Ralf Orzech, Robert Haurand, Jean Marc Jung, Christian Kelm, Malte Westenfeld, Ralf Horn, Patrick Sci Rep Article In-hospital cardiac arrest (IHCA) is associated with poor outcomes. There are currently no standards for cardiac arrest teams in terms of member composition and task allocation. Here we aimed to compare two different cardiac arrest team concepts to cover IHCA management in terms of survival and neurological outcomes. This prospective study enrolled 412 patients with IHCA from general medical wards. From May 2014 to April 2016, 228 patients were directly transferred to the intensive care unit (ICU) for ongoing resuscitation. In the ICU, resuscitation was extended to advanced cardiac life support (ACLS) (Load-and-Go [LaG] group). By May 2016, a dedicated cardiac arrest team provided by the ICU provided ACLS in the ward. After return of spontaneous circulation (ROSC), the patients (n = 184) were transferred to the ICU (Stay-and-Treat [SaT] group). Overall, baseline characteristics, aetiologies, and characteristics of cardiac arrest were similar between groups. The time to endotracheal intubation was longer in the LaG group than in the SaT group (6 [5, 8] min versus 4 [2, 5] min, p = 0.001). In the LaG group, 96% of the patients were transferred to the ICU regardless of ROSC achievement. In the SaT group, 83% of patients were transferred to the ICU (p = 0.001). Survival to discharge did not differ between the LaG (33%) and the SaT (35%) groups (p = 0.758). Ultimately, 22% of patients in the LaG group versus 21% in the SaT group were discharged with good neurological outcomes (p = 0.857). In conclusion, we demonstrated that the cardiac arrest team concepts for the management of IHCA did not differ in terms of survival and neurological outcomes. However, a dedicated (intensive care) cardiac arrest team could take some load off the ICU. Nature Publishing Group UK 2021-11-18 /pmc/articles/PMC8602649/ /pubmed/34795366 http://dx.doi.org/10.1038/s41598-021-02027-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Haschemi, Jafer
Erkens, Ralf
Orzech, Robert
Haurand, Jean Marc
Jung, Christian
Kelm, Malte
Westenfeld, Ralf
Horn, Patrick
Comparison of two strategies for managing in-hospital cardiac arrest
title Comparison of two strategies for managing in-hospital cardiac arrest
title_full Comparison of two strategies for managing in-hospital cardiac arrest
title_fullStr Comparison of two strategies for managing in-hospital cardiac arrest
title_full_unstemmed Comparison of two strategies for managing in-hospital cardiac arrest
title_short Comparison of two strategies for managing in-hospital cardiac arrest
title_sort comparison of two strategies for managing in-hospital cardiac arrest
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602649/
https://www.ncbi.nlm.nih.gov/pubmed/34795366
http://dx.doi.org/10.1038/s41598-021-02027-2
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