Frequency of intraoperative cardiac arrest and medium-term survival

CONTEXT AND OBJECTIVE: Although advances in surgical and anesthetic techniques have reduced perioperative morbidity-mortality, the survival rate following cardiac arrest remains low. The aim of this study was to evaluate, over the course of one year, the prevalence of intraoperative cardiac arrest...

Full description

Bibliographic Details
Main Authors: Ilana Sebbag, Maria Jose Carvalho Carmona, Maria Margarita Castro Gonzalez, Hermes Marcel Alcantara, Rolison Gustavo Bravo Lelis, Flavia de Oliveira Toledo, Gustavo Fabio Aranha, Rafael Ximenes do Prado Nuzzi, Jose Otavio Costa Auler Junior
Format: Article
Language:English
Published: Associação Paulista de Medicina
Series:São Paulo Medical Journal
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000500309&lng=en&tlng=en
_version_ 1819200444687187968
author Ilana Sebbag
Maria Jose Carvalho Carmona
Maria Margarita Castro Gonzalez
Hermes Marcel Alcantara
Rolison Gustavo Bravo Lelis
Flavia de Oliveira Toledo
Gustavo Fabio Aranha
Rafael Ximenes do Prado Nuzzi
Jose Otavio Costa Auler Junior
author_facet Ilana Sebbag
Maria Jose Carvalho Carmona
Maria Margarita Castro Gonzalez
Hermes Marcel Alcantara
Rolison Gustavo Bravo Lelis
Flavia de Oliveira Toledo
Gustavo Fabio Aranha
Rafael Ximenes do Prado Nuzzi
Jose Otavio Costa Auler Junior
author_sort Ilana Sebbag
collection DOAJ
description CONTEXT AND OBJECTIVE: Although advances in surgical and anesthetic techniques have reduced perioperative morbidity-mortality, the survival rate following cardiac arrest remains low. The aim of this study was to evaluate, over the course of one year, the prevalence of intraoperative cardiac arrest and the 30-day survival rate after this event in a tertiary teaching hospital. DESIGN AND SETTING: Prospective cohort study in a tertiary teaching hospital. METHODS: Following approval by the institutional ethics committee, anesthetic procedures and cases of intraoperative cardiac arrest between January and December 2007 were evaluated. Patients undergoing cardiac surgery were excluded. The data were gathered prospectively using the modified Utstein model, with evaluation of demographic data, pre-arrest conditions, intraoperative care, care during arrest and postoperative outcome up to the 30th day. The data were recorded by the attending anesthesiologist. RESULTS: During the study period, 40,379 anesthetic procedures were performed, and 52 cases of intraoperative cardiac arrest occurred (frequency of 13:10,000). Among these, 69% presented spontaneous return of circulation after the initial arrest, and only 25% survived for 30 days after the event. The following factors were associated with shorter survival: American Society of Anesthesiologists physical status IV and V, emergency surgery, hemorrhagic events, hypovolemia as the cause of arrest and use of atropine during resuscitation. CONCLUSIONS: Although the frequency of cardiac arrest in the surgical environment has declined and resources to attend to this exist, the survival rate is low. Factors associated with worst prognosis are more frequent in critical patients.
first_indexed 2024-12-23T03:32:20Z
format Article
id doaj.art-3e23c31c7de84d88bf6036a8bc2b0c0d
institution Directory Open Access Journal
issn 1806-9460
language English
last_indexed 2024-12-23T03:32:20Z
publisher Associação Paulista de Medicina
record_format Article
series São Paulo Medical Journal
spelling doaj.art-3e23c31c7de84d88bf6036a8bc2b0c0d2022-12-21T18:01:37ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460131530931410.1590/1516-3180.2013.1315507S1516-31802013000500309Frequency of intraoperative cardiac arrest and medium-term survivalIlana SebbagMaria Jose Carvalho CarmonaMaria Margarita Castro GonzalezHermes Marcel AlcantaraRolison Gustavo Bravo LelisFlavia de Oliveira ToledoGustavo Fabio AranhaRafael Ximenes do Prado NuzziJose Otavio Costa Auler JuniorCONTEXT AND OBJECTIVE: Although advances in surgical and anesthetic techniques have reduced perioperative morbidity-mortality, the survival rate following cardiac arrest remains low. The aim of this study was to evaluate, over the course of one year, the prevalence of intraoperative cardiac arrest and the 30-day survival rate after this event in a tertiary teaching hospital. DESIGN AND SETTING: Prospective cohort study in a tertiary teaching hospital. METHODS: Following approval by the institutional ethics committee, anesthetic procedures and cases of intraoperative cardiac arrest between January and December 2007 were evaluated. Patients undergoing cardiac surgery were excluded. The data were gathered prospectively using the modified Utstein model, with evaluation of demographic data, pre-arrest conditions, intraoperative care, care during arrest and postoperative outcome up to the 30th day. The data were recorded by the attending anesthesiologist. RESULTS: During the study period, 40,379 anesthetic procedures were performed, and 52 cases of intraoperative cardiac arrest occurred (frequency of 13:10,000). Among these, 69% presented spontaneous return of circulation after the initial arrest, and only 25% survived for 30 days after the event. The following factors were associated with shorter survival: American Society of Anesthesiologists physical status IV and V, emergency surgery, hemorrhagic events, hypovolemia as the cause of arrest and use of atropine during resuscitation. CONCLUSIONS: Although the frequency of cardiac arrest in the surgical environment has declined and resources to attend to this exist, the survival rate is low. Factors associated with worst prognosis are more frequent in critical patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000500309&lng=en&tlng=enIntraoperative complicationsHeart arrestCardiopulmonary resuscitationBlood circulationSurvival rate
spellingShingle Ilana Sebbag
Maria Jose Carvalho Carmona
Maria Margarita Castro Gonzalez
Hermes Marcel Alcantara
Rolison Gustavo Bravo Lelis
Flavia de Oliveira Toledo
Gustavo Fabio Aranha
Rafael Ximenes do Prado Nuzzi
Jose Otavio Costa Auler Junior
Frequency of intraoperative cardiac arrest and medium-term survival
São Paulo Medical Journal
Intraoperative complications
Heart arrest
Cardiopulmonary resuscitation
Blood circulation
Survival rate
title Frequency of intraoperative cardiac arrest and medium-term survival
title_full Frequency of intraoperative cardiac arrest and medium-term survival
title_fullStr Frequency of intraoperative cardiac arrest and medium-term survival
title_full_unstemmed Frequency of intraoperative cardiac arrest and medium-term survival
title_short Frequency of intraoperative cardiac arrest and medium-term survival
title_sort frequency of intraoperative cardiac arrest and medium term survival
topic Intraoperative complications
Heart arrest
Cardiopulmonary resuscitation
Blood circulation
Survival rate
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000500309&lng=en&tlng=en
work_keys_str_mv AT ilanasebbag frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT mariajosecarvalhocarmona frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT mariamargaritacastrogonzalez frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT hermesmarcelalcantara frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT rolisongustavobravolelis frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT flaviadeoliveiratoledo frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT gustavofabioaranha frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT rafaelximenesdopradonuzzi frequencyofintraoperativecardiacarrestandmediumtermsurvival
AT joseotaviocostaaulerjunior frequencyofintraoperativecardiacarrestandmediumtermsurvival