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Wagner MK. The importance of actively engaging with close family members during and after in-hospital cardiopulmonary resuscitation in adult patients. Eur J Cardiovasc Nurs 2024; 23:e67-e68. [PMID: 38348691 DOI: 10.1093/eurjcn/zvae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Mette Kirstine Wagner
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen E, Denmark
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2
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Bradfield M, Haywood KL, Mion M, Kayani A, Leckey S. Not just surviving: Towards a quality standard which meets the care and rehabilitation needs of cardiac arrest survivors and their key supporters. Resuscitation 2024; 198:110182. [PMID: 38492715 DOI: 10.1016/j.resuscitation.2024.110182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Affiliation(s)
- M Bradfield
- Resuscitation Council UK, United Kingdom; Faculty of Health and Social Sciences, Bournemouth University, Dorset, United Kingdom; RCUK Quality Standards Group for Care and Rehabilitation of Cardiac Arrest Survivors and Key Supporters - Lay Representative and Cardiac Arrest Survivor, United Kingdom.
| | - K L Haywood
- RCUK Quality Standards Group for Care and Rehabilitation of Cardiac Arrest Survivors and Key Supporters - Lay Representative and Cardiac Arrest Survivor, United Kingdom; Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, United Kingdom
| | - M Mion
- RCUK Quality Standards Group for Care and Rehabilitation of Cardiac Arrest Survivors and Key Supporters - Lay Representative and Cardiac Arrest Survivor, United Kingdom; Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, United Kingdom; Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin School of Medicine, Chelmsford, Essex, United Kingdom
| | - A Kayani
- RCUK Quality Standards Group for Care and Rehabilitation of Cardiac Arrest Survivors and Key Supporters - Lay Representative and Cardiac Arrest Survivor, United Kingdom
| | - S Leckey
- RCUK Quality Standards Group for Care and Rehabilitation of Cardiac Arrest Survivors and Key Supporters - Lay Representative and Cardiac Arrest Survivor, United Kingdom; Northern Ireland Ambulance Service, Belfast, Northern Ireland
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3
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Wagner MK, Christensen J, Christensen KA, Dichman C, Gottlieb R, Kolster I, Hansen CM, Hoff H, Hassager C, Folke F, Winkel BG. A multidisciplinary guideline-based approach to improving the sudden cardiac arrest care pathway: The Copenhagen framework. Resusc Plus 2024; 17:100546. [PMID: 38260118 PMCID: PMC10801323 DOI: 10.1016/j.resplu.2023.100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Although recommended in the European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) Guidelines, a framework for delivering post-cardiac arrest care in a systematic manner in dedicated high-volume cardiac arrest centers is lacking in the existing literature. To our knowledge, the Copenhagen Framework is the only established framework of its kind. The framework comprises management of out-of-hospital cardiac arrest (OHCA) survivors, and follow-up, and rehabilitation. The framework also incorporates research projects on cardiac arrest survivors and their close family members. The overall aim of this paper is to describe a framework made in order to bridge the gaps between international recommendations and delivering high-quality post-resuscitation clinical care, improving the continuity of care for OHCA survivors, access to post-CA rehabilitation, a seamless transition to everyday life, and ultimately patient outcomes in the future.
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Affiliation(s)
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kate Allen Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Camilla Dichman
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Rikke Gottlieb
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ida Kolster
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Carolina Malta Hansen
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Copenhagen Emergency Medical Services, Copenhagen University, Ballerup, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Helle Hoff
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
| | - Christian Hassager
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Fredrik Folke
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Copenhagen Emergency Medical Services, Copenhagen University, Ballerup, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Bo Gregers Winkel
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
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4
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Mion M, Simpson R, Johnson T, Oriolo V, Gudde E, Rees P, Quinn T, Vopelius-Feldt VJ, Gallagher S, Mozid A, Curzen N, Davies J, Swindell P, Pareek N, Keeble TR. British Cardiovascular Intervention Society Consensus Position Statement on Out-of-hospital Cardiac Arrest 2: Post-discharge Rehabilitation. Interv Cardiol 2022; 17:e19. [PMID: 36644623 PMCID: PMC9820137 DOI: 10.15420/icr.2022.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/02/2022] [Indexed: 11/11/2022] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) is a major public health issue that poses significant challenges both in immediate management and long-term follow-up. Survivors of OHCA often experience a combination of complex medical, physical and psychological needs that have a significant impact on quality of life. Guidelines suggest a multi-dimensional follow-up to address both physical and non-physical domains for survivors. However, it is likely that there is substantial unwarranted variation in provision of services throughout the UK. Currently, there is no nationally agreed model for the follow-up of OHCA survivors and there is an urgent need for a set of standards and guidelines in order to ensure equal access for all. Accordingly, the British Cardiovascular Interventional Society established a multi-disciplinary working group to develop a position statement that summarises the most up-to-date evidence and provides guidance on essential and desirable services for a dedicated follow-up pathway for survivors of OHCA.
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Affiliation(s)
- Marco Mion
- MTRC, Anglia Ruskin School of MedicineChelmsford, Essex, UK,Essex Cardiothoracic Centre, MSE TrustBasildon, Essex, UK
| | - Rupert Simpson
- MTRC, Anglia Ruskin School of MedicineChelmsford, Essex, UK,Essex Cardiothoracic Centre, MSE TrustBasildon, Essex, UK
| | - Tom Johnson
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation TrustBristol, UK
| | - Valentino Oriolo
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation TrustBristol, UK,Faculty of Health and Social care, University of the West of EnglandBristol, UK
| | - Ellie Gudde
- MTRC, Anglia Ruskin School of MedicineChelmsford, Essex, UK,Essex Cardiothoracic Centre, MSE TrustBasildon, Essex, UK
| | - Paul Rees
- Barts Interventional Group, Barts Heart CentreLondon, UK
| | - Tom Quinn
- Emergency, Cardiovascular and Critical Care Research Group, Kingston University and St George's, University of LondonLondon, UK
| | | | - Sean Gallagher
- Department of Cardiology, University Hospital of WalesHeath Park, Cardiff, UK
| | - Abdul Mozid
- Leeds Teaching Hospitals NHS Foundation TrustLeeds, UK
| | - Nick Curzen
- Faculty of Medicine, University of SouthamptonSouthampton, UK,Cardiothoracic Care Group, University Hospital SouthamptonSouthampton, UK
| | - John Davies
- MTRC, Anglia Ruskin School of MedicineChelmsford, Essex, UK,Essex Cardiothoracic Centre, MSE TrustBasildon, Essex, UK
| | | | - Nilesh Pareek
- King's College Hospital NHS Foundation trustLondon, UK,School of Cardiovascular Medicine and Sciences, British Heart Failure Centre of Excellence, King's College LondonLondon, UK
| | - Thomas R Keeble
- MTRC, Anglia Ruskin School of MedicineChelmsford, Essex, UK,Essex Cardiothoracic Centre, MSE TrustBasildon, Essex, UK
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5
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Presciutti A, Siry‐Bove B, Newman MM, Elmer J, Grigsby J, Masters KS, Shaffer JA, Vranceanu A, Perman SM. Qualitative Study of Long‐Term Cardiac Arrest Survivors’ Challenges and Recommendations for Improving Survivorship. J Am Heart Assoc 2022; 11:e025713. [PMID: 35861822 PMCID: PMC9707841 DOI: 10.1161/jaha.121.025713] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Cardiac arrest survivorship refers to the lived experience of long‐term survivors of cardiac arrest and the many postdischarge challenges they experience. We aimed to gather a nuanced understanding of these challenges and of survivors' perceptions of ways to improve the recovery process.
Methods and Results
We conducted 15 semistructured, one‐on‐one interviews with cardiac arrest survivor members of the Sudden Cardiac Arrest Foundation; the interviews were conducted by telephone and recorded and transcribed verbatim. We used thematic analysis, informed by the Framework Method, to identify underlying themes regarding cardiac arrest survivorship challenges and recommendations to improve cardiac arrest survivorship. Regarding challenges, the overarching theme was a feeling of unpreparedness to confront postarrest challenges because of lack of resources, education, and appropriate expectations for recovery. Regarding recommendations, we uncovered 3 overarching themes including systemic recommendations (eg, providing appropriate resources and expectations, educating providers about survivorship, following up with survivors, including caregivers in treatment planning), social recommendations (eg, attending peer support groups, spending time with loved ones, providing support resources for family members), and individual coping recommendations (eg, acceptance, resilience, regaining control, seeking treatment, focusing on meaning and purpose).
Conclusions
We described common challenges that survivors of cardiac arrest face, such as lacking resources, education, and appropriate expectations for recovery. Additionally, we identified promising pathways that may improve cardiac arrest survivorship at systemic, social, and individual coping levels. Future studies could use our findings as targets for interventions to support and improve survivorship.
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Affiliation(s)
- Alex Presciutti
- Department of Psychology University of Colorado Denver Denver CO
- Department of Psychiatry Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital Boston MA
- Department of Psychiatry Harvard Medical School Boston MA
| | - Bonnie Siry‐Bove
- Department of Emergency Medicine University of Colorado School of Medicine Denver CO
| | | | - Jonathan Elmer
- University of Pittsburgh School of Medicine, Departments of Emergency Medicine, Critical Care Medicine and Neurology Pittsburgh PA
| | - Jim Grigsby
- Department of Psychology University of Colorado Denver Denver CO
| | - Kevin S. Masters
- Department of Psychology University of Colorado Denver Denver CO
| | | | - Ana‐Maria Vranceanu
- Department of Psychiatry Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital Boston MA
- Department of Psychiatry Harvard Medical School Boston MA
| | - Sarah M. Perman
- Department of Emergency Medicine University of Colorado School of Medicine Denver CO
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6
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Mion M, Magee N, Davis J, Farrell K, Nikolopoulou E, Jessup D, Davies J, Karamasis G, Keeble T. Exploring cognitive impairment in the early stages of an out-of-hospital cardiac arrest - a consecutive case series study. Neuropsychol Rehabil 2022; 33:927-944. [PMID: 35343857 DOI: 10.1080/09602011.2022.2052325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cognitive deficits are common, although often mild, in out-of-hospital cardiac arrest patients. Prevalence and severity of cognitive deficits on discharge from acute hospital, however, are not systematically assessed in clinical practice, and not frequently reported in scientific literature, potentially hindering the development of appropriate follow-up care pathways for these patients. We hereby present data from a consecutive case series of 75 out-of-hospital cardiac arrest patients discharged from our hospital over a period of 16 months; for 46 of them we were able to obtain a cognitive profile around the time of discharge from hospital, with 37 of them experiencing cognitive deficits, ranging from mild to severe. Memory, verbal fluency and cognitive flexibility were the areas more frequently impaired. The patients we were able to assess did not differ for age, cerebral performance category score and time to return of spontaneous circulation from those we were unable to assess. Cognitive deficits were not associated with duration of "no blood flow" during cardiac arrest or with age. Our results suggest that cognitive deficits in the immediate aftermath of out-of-hospital cardiac arrest are common; however, these may be missed due to lack of systematic assessment and use of poorly sensitive cognitive tests.
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Affiliation(s)
- Marco Mion
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK.,Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford
| | - Neil Magee
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK
| | - Jean Davis
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK
| | - Kelly Farrell
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK
| | - Eleni Nikolopoulou
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK
| | - Donna Jessup
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK
| | - John Davies
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK.,Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford
| | - Grigoris Karamasis
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK.,Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford
| | - Thomas Keeble
- Essex Cardio Thoracic CentreBasildon and Thurrock University Hospitals, Basildon, UK.,Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford
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7
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Joshi VL, Christensen J, Lejsgaard E, Taylor RS, Zwisler AD, Tang LH. Effectiveness of rehabilitation interventions on the secondary consequences of surviving a cardiac arrest: a systematic review and meta-analysis. BMJ Open 2021; 11:e047251. [PMID: 34475160 PMCID: PMC8413927 DOI: 10.1136/bmjopen-2020-047251] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM The aim of this systematic review was to assess the effectiveness of rehabilitation interventions on the secondary physical, neurological and psychological consequences of cardiac arrest (CA) for adult survivors. METHODS A literature search of electronic databases (MEDLINE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, Psychological Information Database, Web of Science and Cochrane Central Register of Controlled trials) was conducted for randomised controlled trials (RCTs) and observational studies up to 18 April 2021. The primary outcome was health-related quality of life (HRQoL) and main secondary outcome was neurological function with additional secondary outcomes being survival, rehospitalisation, safety (serious and non-serious adverse events), psychological well-being, fatigue, exercise capacity and physical capacity. Two authors independently screened studies for eligibility, extracted data and assessed risk of bias. RESULTS Three RCTs and 11 observational studies were included (total 721 participants). Study duration ranged from 8 weeks to 2 years. Pooled data from two RCTs showed low-quality evidence for no effect on physical HRQoL (standardised mean difference (SMD) 0.19, (95% CI: -0.09 to 0.47)) and no effect on mental HRQoL (SMD 0.27 (95% CI: -0.01 to 0.55)).Regarding secondary outcomes, very low-quality evidence was found for improvement in neurological function associated with inpatient rehabilitation for CA survivors with acquired brain injury (SMD 0.71, (95% CI: 0.45 to 0.96)) from five observational studies. Two small observational studies found exercise-based rehabilitation interventions to be safe for CA survivors, reporting no serious or non-serious events. CONCLUSIONS Given the overall low quality of evidence, this review cannot determine the effectiveness of rehabilitation interventions for CA survivors on HRQoL, neurological function or other included outcomes, and recommend further high-quality studies be conducted. In the interim, existing clinical guidelines on rehabilitation provision after CA should be followed to meet the high burden of secondary consequences suffered by CA survivors. PROSPERO REGISTRATION NUMBER CRD42018110129.
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Affiliation(s)
- Vicky L Joshi
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Jan Christensen
- Department of Occupational- and Physiotherapy, Copenhagen University Hospital, København, Denmark
| | - Esben Lejsgaard
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Rod S Taylor
- 3MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - Ann Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
| | - Lars H Tang
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Slagelse, Sjaelland, Denmark
- The Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
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8
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Moving beyond survival and navigating survivorship: Mind the gaps! Resuscitation 2021; 167:395-397. [PMID: 34371145 DOI: 10.1016/j.resuscitation.2021.07.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/27/2023]
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9
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Horowitz JM, Owyang C, Perman SM, Mitchell OJL, Yuriditsky E, Sawyer KN, Blewer AL, Rittenberger JC, Ciullo A, Hsu CH, Kotini-Shah P, Johnson N, Morgan RW, Moskowitz A, Dainty KN, Fleitman J, Uzendu AI, Abella BS, Teran F. The Latest in Resuscitation Research: Highlights From the 2020 American Heart Association's Resuscitation Science Symposium. J Am Heart Assoc 2021; 10:e021575. [PMID: 34369175 PMCID: PMC8475047 DOI: 10.1161/jaha.121.021575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Clark Owyang
- Department of Emergency Medicine and Division of Pulmonary and Critical Care Medicine Weill Cornell Medicine New York City NY
| | - Sarah M Perman
- Department of Emergency Medicine University of Colorado School of Medicine Aurora CO
| | - Oscar J L Mitchell
- Division of Pulmonary and Critical Care Department of Medicine University of Pennsylvania Philadelphia PA
| | | | - Kelly N Sawyer
- Department of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh PA
| | - Audrey L Blewer
- Department of Family Medicine and Community Health Duke University Durham NC
| | - Jon C Rittenberger
- Guthrie-Robert Packer Hospital Emergency Medicine Residency Geisinger Commonwealth Medical College Sayre PA
| | - Anna Ciullo
- Division of Emergency Medicine Department of Surgery University of Utah Health Salt Lake City UT
| | - Cindy H Hsu
- Department of Emergency Medicine Department of Surgery Michigan Center for Integrative Research in Critical Care Michigan Medicine University of Michigan Ann Arbor MI
| | - Pavitra Kotini-Shah
- Department of Emergency Medicine University of Illinois College of Medicine at Chicago Chicago IL
| | - Nicholas Johnson
- Division of Pulmonary, Critical Care, & Sleep Medicine Department of Emergency Medicine University of Washington Seattle WA
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine at Children's Hospital of Philadelphia Philadelphia PA
| | - Ari Moskowitz
- Division of Critical Care Medicine Montefiore Medical Center Bronx, New York NY
| | - Katie N Dainty
- North York General Hospital University of Toronto Toronto Canada
| | - Jessica Fleitman
- Division of Cardiology University of Pennsylvania Philadelphia PA
| | - Anezi I Uzendu
- Division of Cardiology Massachusetts General Hospital Boston MA
| | - Benjamin S Abella
- Department of Emergency Medicine Center for Resuscitation Science University of Pennsylvania Philadelphia PA
| | - Felipe Teran
- Department of Emergency Medicine Center for Resuscitation Science University of Pennsylvania Philadelphia PA
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10
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Mion M, Case R, Smith K, Lilja G, Blennow Nordström E, Swindell P, Nikolopoulou E, Davis J, Farrell K, Gudde E, Karamasis GV, Davies JR, Toff WD, Abella BS, Keeble TR. Follow-up care after out-of-hospital cardiac arrest: A pilot study of survivors and families' experiences and recommendations. Resusc Plus 2021; 7:100154. [PMID: 34386781 PMCID: PMC8342775 DOI: 10.1016/j.resplu.2021.100154] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background and objectives Cognitive and physical difficulties are common in survivors of out-of-hospital cardiac arrest (OHCA); both survivors and close family members are also at risk of developing mood disorders. In the UK, dedicated follow-up pathways for OHCA survivors and their family are lacking. A cohort of survivors and family members were surveyed regarding their experience of post-discharge care and their recommended improvements. Method 123 OHCA survivors and 39 family members completed questionnaires during an educational event or later online. Questions addressed both the actual follow-up offered and the perceived requirements for optimal follow-up from the patient and family perspective, including consideration of timing, professionals involved, involvement of family members and areas they felt should be covered. Results Outpatient follow-up was commonly arranged after OHCA (77%). This was most often conducted by a cardiologist alone (80%) but survivors suggested that other professionals should also be involved (e.g. psychologist/counsellor, 64%). Topics recommended for consideration included cardiac arrest-related issues (heart disease; cause of arrest) mental fatigue/sleep disturbance, cognitive problems, emotional problems and daily activities. Most survivors advocated an early review (<1month; 61%). Most family members reported some psychological difficulties (95%); many of them (95%) advocated a dedicated follow-up appointment for family members of survivors. Conclusions The majority of OHCA survivors advocated an early follow-up following hospital discharge and a holistic, multidimensional assessment of arrest sequelae. These results suggest that current OHCA follow-up often fails to address patient-centred issues and to provide access to professionals deemed important by survivors and family members.
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Affiliation(s)
- Marco Mion
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - Rosalind Case
- The Florey Institute of Neuroscience& Mental Health, Heidelberg, Victoria 3084, Australia
| | - Karen Smith
- Department of Epidemiology and Preventive Medicine, and Department of Community Emergency Health and Paramedic Practice, Monash University. University of Western Australia, Australia
| | - Gisela Lilja
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Erik Blennow Nordström
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | | | - Eleni Nikolopoulou
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Jean Davis
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Kelly Farrell
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Ellie Gudde
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Grigoris V Karamasis
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - John R Davies
- Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - William D Toff
- Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Cardiovascular Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Benjamin S Abella
- Center for Resuscitation Science, University of Pennsylvania, Philadelphia, USA
| | - Thomas R Keeble
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
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11
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Vogelsong MA, Hirsch KG. Beyond the 'Good' in good neurologic outcome: Recovery as a critical link in the chain of survival after cardiac arrest. Resuscitation 2021; 165:177-178. [PMID: 34224790 DOI: 10.1016/j.resuscitation.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Melissa A Vogelsong
- Division of Cardiac Anesthesia, Department of Anesthesiology, Stanford University, Stanford, CA, United States
| | - Karen G Hirsch
- Division of Neurocritical Care, Department of Neurology, Stanford University, Stanford, CA United States.
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12
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Olasveengen TM, Skrifvars MB, Taccone F, Soar J. Postreanimationsbehandlung. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00892-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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13
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14
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Presciutti A, Newman MM, Sawyer KN, Agarwal S, Perman SM. Gaps in the Provision of Cognitive and Psychological Resources in Cardiac Arrest Survivors with Good Neurologic Recovery. Ther Hypothermia Temp Manag 2021; 12:61-67. [PMID: 33978474 DOI: 10.1089/ther.2021.0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We aimed to elucidate gaps in the provision of cognitive and psychological resources in cardiac arrest survivors. We conducted an online survey study between October 29, 2019, and November 15, 2019 with cardiac arrest survivors and caregiver members of the Sudden Cardiac Arrest Foundation. We queried survivors as to whether they experienced cognitive or psychological symptoms since their cardiac arrest. Next, we queried both survivors and caregivers on the provision of resources through three metrics: (1) discussions with providers about potential cognitive or psychological symptoms, (2) neurologist or psychologist appointments scheduled by providers, and (3) mental health referrals by providers. We then ran Chi-square goodness-of-fit tests to compare the proportion of survivors and caregivers who reported resource provision (observed values) to the proportion of survivors who reported experiencing cognitive and psychological symptoms, respectively (expected values). We included responses from 167 survivors and 52 caregivers. A total of 73.1% (n = 122) survivors reported experiencing cognitive symptoms and 67.1% (n = 112) psychological symptoms since their cardiac arrest. When compared to these two proportions, provision of resources was significantly lower in all three metrics: (1) fewer discussions with providers about potential for developing cognitive symptoms (31%) and psychological symptoms (26.3%), (2) fewer neurologist appointments scheduled (8.4%) and psychologist appointments scheduled (4.8%), and (3) fewer referrals to mental health (6%). Informal caregivers also reported significantly lower provision of resources in all three metrics, with the exception of discussions about developing cognitive symptoms. Our results suggest that there are discrepancies in the provision of cognitive and psychological resources in cardiac arrest survivors with good neurologic recovery. Systematic referral processes may be needed to standardize resource provision to consistently meet the pervasive cognitive and psychological needs of cardiac arrest survivors.
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Affiliation(s)
- Alex Presciutti
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Mary M Newman
- Sudden Cardiac Arrest Foundation, Pittsburgh, Pennsylvania, USA
| | - Kelly N Sawyer
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sachin Agarwal
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Sarah M Perman
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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15
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Kim YM, Jeung KW, Kim WY, Park YS, Oh JS, You YH, Lee DH, Chae MK, Jeong YJ, Kim MC, Ha EJ, Hwang KJ, Kim WS, Lee JM, Cha KC, Chung SP, Park JD, Kim HS, Lee MJ, Na SH, Kim ARE, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care. Clin Exp Emerg Med 2021; 8:S41-S64. [PMID: 34034449 PMCID: PMC8171174 DOI: 10.15441/ceem.21.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/07/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Young-Min Kim
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyung Woon Jeung
- Department of Emergency Medicine, Chonnam National University College of Medicine, Gwangju, Korea
| | - Won Young Kim
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Yoo Seok Park
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Suk Oh
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yeon Ho You
- Department of Emergency Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Dong Hoon Lee
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Minjung Kathy Chae
- Department of Emergency Medicine, Ajou University College of Medicine, Suwon, Korea
| | - Yoo Jin Jeong
- Department of Emergency Medicine, Chonnam National University College of Medicine, Gwangju, Korea
| | - Min Chul Kim
- Department of Internal Medicine, Chonnam National University College of Medicine, Gwangju, Korea
| | - Eun Jin Ha
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Jin Hwang
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Myung Lee
- Department of General Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kyoung-Chul Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - June Dong Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Mi Jin Lee
- Department of Emergency Medicine, Kyoungbook University College of Medicine, Daegu, Korea
| | - Sang-Hoon Na
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ai-Rhan Ellen Kim
- Department of Pediatrics, Ulsan University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - on behalf of the Steering Committee of 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Chonnam National University College of Medicine, Gwangju, Korea
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Ajou University College of Medicine, Suwon, Korea
- Department of Internal Medicine, Chonnam National University College of Medicine, Gwangju, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Department of General Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Emergency Medicine, Kyoungbook University College of Medicine, Daegu, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Ulsan University College of Medicine, Seoul, Korea
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16
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Paratz ED, Rowsell L, van Heusden A, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Ingles J, Case R, Ball J, Smith K, Stub D, La Gerche A. The End Unexplained Cardiac Death (EndUCD) Registry for Young Australian Sudden Cardiac Arrest. Heart Lung Circ 2021; 30:714-720. [DOI: 10.1016/j.hlc.2020.09.937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
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17
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Paratz ED, Smith K, Ball J, van Heusden A, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Stub D, Liew D, La Gerche A. The economic impact of sudden cardiac arrest. Resuscitation 2021; 163:49-56. [PMID: 33865963 DOI: 10.1016/j.resuscitation.2021.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/15/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are 20,000 sudden cardiac arrests (SCAs) in Australia annually, with 90% case-fatality. OBJECTIVE The present study calculated both the health and economic impact of SCAs in Victoria, Australia. METHODS Data on all SCAs attended by Ambulance Victoria from July 2017 to June 2018 were collected regarding age, gender, and survival to hospital, discharge and 12 months. Pre-SCA employment status of all patients was modelled using age and gender-matched Australian economic data. A Markov state-transition model with a five-year horizon calculated health and economic impact in years of life lived (YLL), productivity-adjusted life years (PALYs) and gross domestic product (GDP) lost. A counterfactual Markov state-transition model assessed outcomes of an identical cohort of patients who did not experience SCA. All values were discounted by 5%. RESULTS In 12 months, 4637 people suffered SCAs in Victoria, of whom 1516 (32.7%) were working at the time. 695 patients (15.0%) survived to hospital, 325 (7.0%) to discharge, and 303 (6.5%) to 12 months. In five years following their SCA, the cohort lost 15,922 years of life and 2327 PALYs. Reduced productivity led to GDP losses of AUD$448 million (92.8% relative reduction). Extrapolated to the 20,000 SCAs occurring across all of Australia, total GDP losses approached AUD$2 billion. CONCLUSION The health and economic burden of SCAs is high, predominantly underpinned by very high mortality. Annual national losses approach AUD$2 billion (USD$1.42 billion) and are comparable to productivity losses from all cancers combined. Prioritising research and state-of-the-art care for SCA patients appears economically sound.
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Affiliation(s)
- Elizabeth D Paratz
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC, 3065, Australia.
| | - Karen Smith
- Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Paramedicine, Monash University, Melbourne, VIC, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | - Jocasta Ball
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | | | - Dominica Zentner
- Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia; Royal Melbourne Hospital Clinical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Sarah Parsons
- Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia; Department of Forensic Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia
| | - Natalie Morgan
- Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia
| | - Tina Thompson
- Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia
| | - Paul James
- Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia
| | - Andreas Pflaumer
- Royal Children's Hospital, 50 Flemington Rd Parkville, Melbourne, VIC, 3052, Australia; Department of Paediatrics, Melbourne University, Parkville, VIC, 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC, 3052, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, The University of Sydney, Missenden Rd, Sydney, NSW, 2050, Australia
| | - Dion Stub
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | - Danny Liew
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC, 3065, Australia
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18
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Olasveengen TM, Skrifvars MB, Taccone F, Soar J. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med 2021; 47:369-421. [PMID: 33765189 PMCID: PMC7993077 DOI: 10.1007/s00134-021-06368-4] [Citation(s) in RCA: 417] [Impact Index Per Article: 139.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022]
Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation and organ donation.
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Affiliation(s)
- Jerry P. Nolan
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL UK
- Royal United Hospital, Bath, BA1 3NG UK
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
- Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Straße 62, 50937 Cologne, Germany
| | - Alain Cariou
- Cochin University Hospital (APHP) and University of Paris (Medical School), Paris, France
| | - Tobias Cronberg
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences, Anaesthesia and Intensive Care Medicine, Lund University, Skane University Hospital, Lund, Sweden
| | - Cornelia Genbrugge
- Acute Medicine Research Pole, Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
- Emergency Department, University Hospitals Saint-Luc, Brussels, Belgium
| | - Kirstie Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A108, Coventry, CV4 7AL UK
| | - Gisela Lilja
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Véronique R. M. Moulaert
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nikolaos Nikolaou
- Cardiology Department, Konstantopouleio General Hospital, Athens, Greece
| | - Theresa Mariero Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Markus B. Skrifvars
- Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Fabio Taccone
- Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB UK
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19
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Mariero Olasveengen T, Skrifvars MB, Taccone F, Soar J. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation 2021; 161:220-269. [PMID: 33773827 DOI: 10.1016/j.resuscitation.2021.02.012] [Citation(s) in RCA: 338] [Impact Index Per Article: 112.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation.
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Affiliation(s)
- Jerry P Nolan
- University of Warwick, Warwick Medical School, Coventry CV4 7AL, UK; Royal United Hospital, Bath, BA1 3NG, UK.
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bernd W Böttiger
- University Hospital of Cologne, Kerpener Straße 62, D-50937 Cologne, Germany
| | - Alain Cariou
- Cochin University Hospital (APHP) and University of Paris (Medical School), Paris, France
| | - Tobias Cronberg
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences, Anaesthesia and Intensive Care Medicine, Lund University, Skane University Hospital, Lund, Sweden
| | - Cornelia Genbrugge
- Acute Medicine Research Pole, Institute of Experimental and Clinical Research (IREC) Université Catholique de Louvain, Brussels, Belgium; Emergency Department, University Hospitals Saint-Luc, Brussels, Belgium
| | - Kirstie Haywood
- Warwick Research in Nursing, Room A108, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Gisela Lilja
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Véronique R M Moulaert
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Nikolaos Nikolaou
- Cardiology Department, Konstantopouleio General Hospital, Athens, Greece
| | - Theresa Mariero Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Markus B Skrifvars
- Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Finland
| | - Fabio Taccone
- Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
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20
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Abstract
In this section of the European Resuscitation Council Guidelines 2021, key information on the epidemiology and outcome of in and out of hospital cardiac arrest are presented. Key contributions from the European Registry of Cardiac Arrest (EuReCa) collaboration are highlighted. Recommendations are presented to enable health systems to develop registries as a platform for quality improvement and to inform health system planning and responses to cardiac arrest.
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21
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Cronberg T, Greer DM, Lilja G, Moulaert V, Swindell P, Rossetti AO. Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation. Lancet Neurol 2020; 19:611-622. [PMID: 32562686 DOI: 10.1016/s1474-4422(20)30117-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 02/08/2023]
Abstract
More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about the prognosis should be delayed at least 72 h after arrest to allow for the clearance of sedative drugs. Cognitive impairments, emotional problems, and fatigue are common among patients who have survived cardiac arrest, and often go unrecognised despite being related to caregiver burden and a decreased participation in society. Through simple screening, these problems can be identified, and patients can be provided with adequate information and rehabilitation.
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Affiliation(s)
- Tobias Cronberg
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden.
| | - David M Greer
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Gisela Lilja
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Véronique Moulaert
- Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Netherlands
| | | | - Andrea O Rossetti
- Department of Clinical Neurosciences, University Hospital and University of Lausanne, Lausanne, Switzerland
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22
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Presciutti A, Shaffer JA, Newman M, Perman SM. Modifiable provider-patient relationship factors and illness perceptions are associated with quality of life in survivors of cardiac arrest with good neurologic recovery. Resusc Plus 2020; 3:100008. [PMID: 34223295 PMCID: PMC8244500 DOI: 10.1016/j.resplu.2020.100008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 11/26/2022] Open
Abstract
Aim To evaluate associations between provider-patient communication, readiness for discharge, and patients' illness perceptions with post-arrest quality of life (QoL). Methods We distributed an online survey to survivors of cardiac arrest who were members of the Sudden Cardiac Arrest Foundation. Survivors completed the Questionnaire for the Quality of Provider-Patient Interactions (QQPPI), Readiness for Hospital Discharge Scale (RHDS), and the Brief Illness Perception Questionnaire (B-IPQ). When completing the QQPPI and RHDS, survivors were asked to think back to their hospitalization and discharge. QoL domains (physical, psychological, social) were measured via the WHO-QOL BREF. Three multiple regression models examined associations between QQPPI, RHDS, and B-IPQ scores with QoL domains, adjusted for age, sex, months since arrest, self-reported understanding of cardiac arrest and potential post-arrest symptoms at discharge, self-reported memory at discharge, and functional status as defined by the Lawton Instrumental Activities of Daily Living scale. Results A total of 163 survivors (mean age: 50.1 years, 50.3% women, 95.5% white, mean time since arrest: 63.9 months) provided complete survey data. More threatening illness perceptions (β: -0.45, p < 0.001) and lower readiness for discharge (β: 0.21, p = 0.01) were associated with worse physical QoL. More threatening illness perceptions (β: -0.47, p < 0.001) was associated with worse psychological QoL. More threatening illness perceptions (β: -0.28, p = 0.001) and poor provider-patient communication (β: 0.35, p < 0.001) were associated with worse social QoL. Conclusions Modifiable provider-patient relationship factors and illness perceptions were associated with quality of life in survivors of cardiac arrest with good neurologic recovery.
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Affiliation(s)
- Alex Presciutti
- Department of Psychology, University of Colorado Denver, USA
| | | | | | - Sarah M Perman
- Department of Emergency Medicine, University of Colorado Anschutz, USA
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