Characteristics of in-hospital cardiac arrest and cardiopulmonary resuscitation

Aim We have studied epidemiology of in-hospital cardiac arrest, characteristics of organizing a reanimation and its,procedures as well as its documenting. Methods We analyzed all resuscitation procedure data where anesthesiology reanimation teams (RT) provided cardiopulmonary resuscitation (CPR) during one-year period. We included resuscitation attempts that were initiated outside the Department of Anesthesiology, excluding incidents in operation rooms and Intensive Care Unit (ICU). Data on every cardiac arrest and CPR were entered in a special form. Results During one-year period 87 CPR were performed. Victims of cardiac arrest were principally elderly patients (age 60 - 80), mostly male (60%). Most frequent victims were neurological patients (42%), surgical patients (21%) and neurosurgical patients (10%). The leading cause of cardiac arrest was primary heart disease, following neurological diseases and respiration disorders of severe etiology. In over 90% cases CPR was initiated by medical personnel in their respective departments, RT arrived within 5 minutes in 73,56% cases. Initially survival was 32%, but full recovery was accomplished in 4 patients out of 87 (4,6%). Conclusion Victims of cardiac arrest are patients whose primary disease contributes to occurrence of cardiorespiratory complications. High mortality and low percentage of full recovery can be explained by characteristics of patients (old age, nature and seriousness of primary disease) which significantly affect the outcome of CPR. In some cases a question is raised whether to initiate the CPR at all. We would like to point out that continous monitoring of potentially critical patients may prevent cardiorespiratory incidents whereas the quality and success of CPR may be improved by training of staff and better technical equipment on the relevant locations in the in the hospital where such incidents usually occur.