Comparison of two strategies for managing in-hospital cardiac arrest

Abstract 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...

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Autores principales:	Jafer Haschemi, Ralf Erkens, Robert Orzech, Jean Marc Haurand, Christian Jung, Malte Kelm, Ralf Westenfeld, Patrick Horn
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/92d4a7d0f06741758e0689e8044d9c19
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spelling	oai:doaj.org-article:92d4a7d0f06741758e0689e8044d9c192021-11-21T12:18:55ZComparison of two strategies for managing in-hospital cardiac arrest10.1038/s41598-021-02027-22045-2322https://doaj.org/article/92d4a7d0f06741758e0689e8044d9c192021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02027-2https://doaj.org/toc/2045-2322Abstract 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.Jafer HaschemiRalf ErkensRobert OrzechJean Marc HaurandChristian JungMalte KelmRalf WestenfeldPatrick HornNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jafer Haschemi Ralf Erkens Robert Orzech Jean Marc Haurand Christian Jung Malte Kelm Ralf Westenfeld Patrick Horn Comparison of two strategies for managing in-hospital cardiac arrest
description	Abstract 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.
format	article
author	Jafer Haschemi Ralf Erkens Robert Orzech Jean Marc Haurand Christian Jung Malte Kelm Ralf Westenfeld Patrick Horn
author_facet	Jafer Haschemi Ralf Erkens Robert Orzech Jean Marc Haurand Christian Jung Malte Kelm Ralf Westenfeld Patrick Horn
author_sort	Jafer Haschemi
title	Comparison of two strategies for managing in-hospital cardiac arrest
title_short	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_sort	comparison of two strategies for managing in-hospital cardiac arrest
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/92d4a7d0f06741758e0689e8044d9c19
work_keys_str_mv	AT jaferhaschemi comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT ralferkens comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT robertorzech comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT jeanmarchaurand comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT christianjung comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT maltekelm comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT ralfwestenfeld comparisonoftwostrategiesformanaginginhospitalcardiacarrest AT patrickhorn comparisonoftwostrategiesformanaginginhospitalcardiacarrest
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Comparison of two strategies for managing in-hospital cardiac arrest

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