Peri-operative cardiac arrest: management and outcomes of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists

被引：19

作者：

Armstrong, R. A. ^{[1
,2
]}

Cook, T. M. ^{[3
,4
]}

Kane, A. D. ^{[1
,5
]}

Kursumovic, E. ^{[1
,3
]}

Nolan, J. P. ^{[6
]}

Oglesby, F. C. ^{[7
]}

Cortes, L.

Taylor, C.

Moppett, I. K. ^{[8
]}

Agarwal, S. ^{[9
]}

Cordingley, J. ^{[10
]}

Davies, M. T. ^{[11
]}

Dorey, J.

Finney, S. J. ^{[10
]}

Kendall, S. ^{[12
,13
]}

Kunst, G. ^{[14
]}

Lucas, D. N. ^{[15
]}

Mouton, R. ^{[16
]}

Nickols, G. ^{[16
]}

Pappachan, V. J. ^{[17
,18
]}

Patel, B.

Plaat, F. ^{[19
]}

Scholefield, B. R. ^{[20
]}

Smith, J. H. ^{[21
]}

Varney, L. ^{[22
]}

Wain, E. ^{[23
]}

Soar, J. ^{[24
]}

机构：

[1] Royal Coll Anaesthetists, Hlth Serv Res Ctr, Res Team 8, 9 Director, 14 Lay Comm, London, England

[2] Severn Deanery, Bristol, England

[3] Royal United Hosp Bath NHS Fdn Trust, Dept Anaesthesia & Intens Care Med, Bath, England

[4] Univ Bristol, Bristol, England

[5] James Cook Univ Hosp, South Tees NHS Fdn Trust, Dept Anaesthesia, Middlesbrough, England

[6] Univ Warwick, Warwick Clin Trials Unit, Resuscitat Med, Coventry, England

[7] Univ Hosp Bristol & Weston NHS Fdn Trust, Bristol, England

[8] Univ Nottingham, Anaesthesia & Peri Operat Med, Nottingham, England

[9] Manchester Univ Hosp Fdn Trust, Dept Anaesthesia, Manchester, England

[10] Barts Hlth NHS Trust, Dept Crit Care & Anaesthesia, London, England

[11] North West Anglia NHS Trust, Dept Crit Care & Anaesthesia, Peterborough, England

[12] Royal Coll Surgeons England, London, England

[13] NHS England North East & Yorkshire, York, England

[14] Kings Coll London, Dept Cardiovasc Anaesthesia, London, England

[15] London North West Univ Healthcare NHS Trust, Dept Anaesthesia, London, England

[16] North Bristol NHS Trust, Dept Anaesthesia, Bristol, England

[17] Southampton Childrens Hosp, NIHR Biomed Res Ctr, Southampton, England

[18] Univ Hosp Southampton NHS Fdn Trust, Dept Paediat Anaesthesia & Intens Care Med, Southampton, England

[19] Imperial Coll Healthcare NHS Trust, Dept Anaesthesia, London, England

[20] Univ Birmingham, Inst Inflammat & Ageing, Birmingham, England

[21] Great Ormond St Hosp Sick Children, Dept Anaesthesia, London, England

[22] Univ Coll London Hosp, Dept Anaesthesia, London, England

[23] Robert Jones & Agnes Hunt Orthopaed & Dist Hosp, Dept Anaesthesia, Gobowen, England

[24] Southmead Hosp, Dept Anaesthesia & Intens Care Med, Bristol, England

来源：

ANAESTHESIA | 2024年 / 79卷 / 01期

关键词：

anaesthesia; NAP7; peri-operative cardiac arrest; RESUSCITATION;

D O I：

10.1111/anae.16157

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

The 7th National Audit Project of the Royal College of Anaesthetists studied peri-operative cardiac arrest in the UK, a topic of importance to patients, anaesthetists and surgeons. We report the results of the 12-month registry phase, from 16 June 2021 to 15 June 2022, focusing on management and outcomes. Among 881 cases of peri-operative cardiac arrest, the initial rhythm was non-shockable in 723 (82%) cases, most commonly pulseless electrical activity. There were 665 (75%) patients who survived the initial event and 384 (52%) who survived to hospital discharge. A favourable functional outcome (based on modified Rankin Scale score) was reported for 249 (88%) survivors. Outcomes varied according to arrest rhythm. The highest rates of survival were seen for bradycardic cardiac arrests with 111 (86%) patients surviving the initial event and 77 (60%) patients surviving the hospital episode. The lowest survival rates were seen for patients with pulseless electrical activity, with 312 (68%) surviving the initial episode and 156 (34%) surviving to hospital discharge. Survival to hospital discharge was worse in patients at the extremes of age with 76 (40%) patients aged > 75 y and 9 (45%) neonates surviving. Hospital survival was also associated with surgical priority, with 175 (88%) elective patients and 176 (37%) non-elective patients surviving to discharge. Outcomes varied with the cause of cardiac arrest, with lower initial survival rates for pulmonary embolism (5, 31%) and bone cement implantation syndrome (9, 45%), and hospital survival of < 25% for pulmonary embolism (0), septic shock (13, 24%) and significant hyperkalaemia (1, 20%). Overall care was rated good in 464 (53%) cases, and 18 (2%) cases had overall care rated as poor. Poor care elements were present in a further 245 (28%) cases. Care before cardiac arrest was the phase most frequently rated as poor (92, 11%) with elements of poor care identified in another 186 (21%) cases. These results describe the management and outcomes of peri-operative cardiac arrest in UK practice for the first time.

引用

页码：31 / 42

页数：12

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