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Review and Outcome of Prolonged Cardiopulmonary Resuscitation


Affiliations
1 University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States
2 Lebanese American University, Lebanon
 

The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. Themain causes of the cardiac arrests weremyocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74%of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts.
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  • Review and Outcome of Prolonged Cardiopulmonary Resuscitation

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Authors

Houssein Youness
University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States
Tarek Al Halabi
Lebanese American University, Lebanon
Hussein Hussein
University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States
Ahmed Awab
University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States
Kellie Jones
University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States
Jean Keddissi
University of Oklahoma, 920 Stanton L Young Boulevard,WP 1310, Oklahoma City, OK 73104, United States

Abstract


The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. Themain causes of the cardiac arrests weremyocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74%of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts.