Study On The Duration Of Resuscitation Efforts In Patients With In-hospital Cardiac Arrest

Background The mortality rate of patients with in-hospital cardiac arrest is high,but the reasonable duration of resuscitation efforts for them remains unclear.Objectives We aimed to explore the rationality of 30 minutes as the routine duration of resuscitation efforts.We aimed to study the influence of gender,age,initial cardiac rhythm and etiology on the duration of resuscitation efforts.Methods We analyzed the records of patients with in-hospital cardiac arrest in 14 emergency departments of tertiary comprehensive hospitals in China between December 1,2013 to December 31,2014.We divided the patients into routine group and prolonged cardiopulmonary resuscitation group,and compared the basic information,etiology and prognosis of the two groups.We grouped patients in the light of gender,age,initial cardiac rhythm and etiology,and compared the duration of resuscitation efforts among different groups.We divided the patients into manual chest compression group and mechanical chest compression group,and compared the prognosis between the two groups.Results Compared with patients in prolonged cardiopulmonary resuscitation group,patients in routine group had significant higher rates of ROSC and survival rate to hospital discharge(67.5%vs 7.4%,10.1%vs 0).The duration of resuscitation efforts in patients with ROSC showed no statistically difference among different gender,age and initial rhythm(P>0.05).Patients with ROSC who suffered from trauma showed shorter duration of resuscitation efforts than patients who suffered from arrhythmia,heart failure,pulmonary embolism.Patients with ROSC who suffered from pulmonary embolism showed longer duration of resuscitation efforts than patients who suffered from acute myocardial infarction,arrhythmia,heart failure,severe pneumonia,trauma,sepsis and stroke.As for survival rate to hospital discharge,there was no statistically difference between manual chest compressions group and mechanical chest compressions group(P>0.05).Conclusions Prolonged cardiopulmonary resuscitation can improve the total ROSC rate of IHCA patients,but cannot improve the survival rate.Prolonged cardiopulmonary resuscitation is meaningful for IHCA patients caused by pulmonary embolism.Mechanical chest compression is reasonable when it comes to prolonged cardiopulmonary resuscitation.