Results of the implementation of integrated care after cardiorespiratory arrest in a university hospital.
Evelyn Carla Borsari Mauricio, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista and 2 others
PMID 30020334WHAT IT FOUND
Only 13 of 88 patients survived to discharge after cardiac arrest with return of spontaneous circulation, 10 at six months and 9 at one year.
Some post-arrest care measures were associated with survival, but none were associated with neurological status at discharge.
Key findings
01Of 88 patients, 13 survived to discharge, 10 survived at six months, and 9 survived at one year.
02Capnography, venous oxygen saturation monitoring, and electroencephalogram were not performed in any patient.
03None of the post-cardiac arrest care measures were associated with neurological status in the first 24 hours or at hospital discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one emergency room, so it may not represent other hospitals. It was a retrospective record review, and 8 of 88 charts did not contain enough information for care-measure analysis. Only 13 patients survived to discharge, 10 at six months, and 9 at one year, so later survival associations are based on small numbers. The study reports associations, not randomized comparisons, so it cannot show that a care measure caused survival or better neurological status. The methods describe out-of-hospital cardiac arrest, but the results table shows most events occurred in hospital, so the population is not clearly defined.
The easy way to misread this
Do not read the associations between care measures and survival or neurological status as proof that a specific intervention works. Do not conclude that not receiving vasoactive drugs improves neurological status. The study was a retrospective record review with incomplete charts and no randomized comparison.