1
|
Vahedian-Azimi A, Hassan IF, Rahimi-Bashar F, Elmelliti H, Akbar A, Shehata AL, Ibrahim AS, Ait Hssain A. What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study. Int J Emerg Med 2024; 17:56. [PMID: 38632515 PMCID: PMC11022486 DOI: 10.1186/s12245-024-00608-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Extracorporeal cardiopulmonary resuscitation (ECPR) is an alternative method for patients with reversible causes of cardiac arrest (CA) after conventional cardiopulmonary resuscitation (CCPR). However, cardiopulmonary resuscitation (CPR) duration during ECPR can vary due to multiple factors. Healthcare providers need to understand these factors to optimize the resuscitation process and improve outcomes. The aim of this study was to examine the different variables impacting the duration of CPR in patients undergoing ECPR. METHODS This retrospective, single-center, observational study was conducted on adult patients who underwent ECPR due to in-hospital CA (IHCA) or out-of-hospital CA (OHCA) at Hamad General Hospital (HGH), the tertiary governmental hospital of Qatar, between February 2016 and March 2020. Univariate and multivariate binary logistic regression analyses were performed to identify the prognostic factors associated with CPR duration, including demographic and clinical variables, as well as laboratory tests. RESULTS The mean ± standard division age of the 48 participants who underwent ECPR was 41.50 ± 13.15 years, and 75% being male. OHCA and IHCA were reported in 77.1% and 22.9% of the cases, respectively. The multivariate analysis revealed that several factors were significantly associated with an increased CPR duration: higher age (OR: 1.981, 95%CI: 1.021-3.364, P = 0.025), SOFA score (OR: 3.389, 95%CI: 1.289-4.911, P = 0.013), presence of comorbidities (OR: 3.715, 95%CI: 1.907-5.219, P = 0.026), OHCA (OR: 3.715, 95%CI: 1.907-5.219, P = 0.026), and prolonged collapse-to-CPR time (OR: 1.446, 95%CI:1.092-3.014, P = 0.001). Additionally, the study found that the initial shockable rhythm was inversely associated with the duration of CPR (OR: 0.271, 95%CI: 0.161-0.922, P = 0.045). However, no significant associations were found between laboratory tests and CPR duration. CONCLUSION These findings suggest that age, SOFA score, comorbidities, OHCA, collapse-to-CPR time, and initial shockable rhythm are important factors influencing the duration of CPR in patients undergoing ECPR. Understanding these factors can help healthcare providers better predict and manage CPR duration, potentially improving patient outcomes. Further research is warranted to validate these findings and explore additional factors that may impact CPR duration in this population.
Collapse
Affiliation(s)
- Amir Vahedian-Azimi
- Trauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ibrahim Fawzy Hassan
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, PO BOX 3050, Doha, Qatar
| | - Farshid Rahimi-Bashar
- Department of Anesthesiology and Critical Care, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Anzila Akbar
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, PO BOX 3050, Doha, Qatar
| | - Ahmed Labib Shehata
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, PO BOX 3050, Doha, Qatar
| | - Abdulsalam Saif Ibrahim
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, PO BOX 3050, Doha, Qatar
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
- Department of Medicine, Weill Cornell Medical College, PO BOX 3050, Doha, Qatar.
- Medical Intensive Care Unit, ECMO team, Hamad General Hospital, Doha, Qatar.
| |
Collapse
|
2
|
Agarwal A, Baitha U, Ranjan P, Swarnkar NK, Singh GP, Baidya DK, Garg R, Gupta N, Choudhury A, Kumar A, Roy A, Naik N, Khan MA, Wig N. Knowledge and Skills in Cardiopulmonary Resuscitation and Effect of Simulation Training on it among Healthcare Workers in a Tertiary Care Center in India. Indian J Crit Care Med 2024; 28:336-342. [PMID: 38585308 PMCID: PMC10998517 DOI: 10.5005/jp-journals-10071-24670] [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] [Received: 10/25/2023] [Accepted: 01/02/2024] [Indexed: 04/09/2024] Open
Abstract
Aim and background High-quality cardiopulmonary resuscitation (CPR) is associated with improved patient outcomes, but healthcare workers (HCWs) may be frequently undertrained. This study aimed to assess baseline knowledge and skills among HCWs about basic and advanced life support and the effect of simulation-based training on it. Methods It was a single-center prospective quasi-interventional study among resident doctors and nurses at a Tertiary Center in New Delhi, India. A questionnaire-based assessment was done to assess baseline knowledge. The participants then underwent simulation-based training followed by questionnaire-based knowledge assessment and skill assessment. A repeat questionnaire-based assessment was done 6 months post-training to assess knowledge retention. Results A total of 82 HCWs (54 doctors and 28 nurses) were enrolled. The participants scored 22.28 ± 6.06 out of 35 (63.65%) in the pre-training knowledge assessment, with low scores in post-cardiac arrest care, advanced life support, and defibrillation. After the training, there was a significant rise in scores to 28.32 ± 4.08 out of 35 (80.9%) (p < 0.01). The retention of knowledge at 6 months was 68.87% (p < 0.01). The participants scored 92.61 ± 4.75% marks in skill assessment with lower scores in chest compressions and team leadership roles. There was a positive correlation (r = 0.35) between knowledge and skills scores (p < 0.01). Conclusion There is a progressive decrease in baseline knowledge of HCWs with the further steps in the adult chain of survival. The simulation training program had a positive impact on the knowledge of HCWs. The training programs should focus on defibrillation, advanced life support, post-cardiac arrest care, and leadership roles. How to cite this article Agarwal A, Baitha U, Ranjan P, Swarnkar NK, Singh GP, Baidya DK, et al. Knowledge and Skills in Cardiopulmonary Resuscitation and Effect of Simulation Training on it among Healthcare Workers in a Tertiary Care Center in India. Indian J Crit Care Med 2024;28(4):336-342.
Collapse
Affiliation(s)
- Ayush Agarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Neeraj K Swarnkar
- Department of Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Gyaninder P Singh
- Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Dalim K Baidya
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Garg
- Department of Onco-Anaesthesiology and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesiology and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arindam Choudhury
- Department of Cardiac Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nitish Naik
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof Ahmed Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Tandon M, Jindal A, Gupta S, Goel N. Cardiac arrest during laparoscopic cholecystectomy in a patient with systemic sclerosis. Indian J Anaesth 2021; 65:S142-S143. [PMID: 34703061 PMCID: PMC8500196 DOI: 10.4103/ija.ija_402_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/28/2021] [Accepted: 08/28/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Manish Tandon
- Anaesthesia, Dharamshila Narayana Superspeciality Hospital, Delhi, India
| | - Aseem Jindal
- Surgical Gastroenterology, Dharamshila Narayana Superspeciality Hospital, Delhi, India
| | - Sajal Gupta
- Cardiology, Dharamshila Narayana Superspeciality Hospital, Delhi, India
| | - Neeraj Goel
- Surgical Gastroenterology, Dharamshila Narayana Superspeciality Hospital, Delhi, India
| |
Collapse
|
4
|
Ahmed SM, Garg R, Chadha M, Athar M. Need for universal critical care guidelines template: Difficult to choose from many! Indian J Anaesth 2020; 64:S217-S219. [PMID: 33311722 PMCID: PMC7714003 DOI: 10.4103/ija.ija_968_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
- Syed M Ahmed
- Department of Anaesthesiology and Critical Care, J N Medical College, Uttar Pradesh, India
| | - Rakesh Garg
- Dr. BRAIRCH All India Institute of Medical Sciences,Ansari Nagar, New Delhi, India
| | - Meenu Chadha
- Convenient Hospital Limited Hospital, Indore, Madhya Pradesh, India. E-mail:
| | - Manazir Athar
- Department of Anaesthesiology, J N Medical College, AMU, Aligarh, Uttar Pradesh, India
| |
Collapse
|
5
|
Solanki SL, Johnson JE, Samantaray A. Supraglottic airway devices: Placement and pharyngeal seal matters! Indian J Anaesth 2020; 64:649-652. [PMID: 32934398 PMCID: PMC7457984 DOI: 10.4103/ija.ija_938_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
- Sohan Lal Solanki
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India. E-mail:
| | - J Edward Johnson
- Department of Anaesthesiology, Kanyakumari Govt Medical College, Nagarcoil, Tamil Nadu, India
| | - Aloka Samantaray
- Department of Anaesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| |
Collapse
|
6
|
Singh B, Garg R, Chakra Rao SSC, Ahmed SM, Divatia JV, Ramakrishnan TV, Mehdiratta L, Joshi M, Malhotra N, Bajwa SJS. Indian Resuscitation Council (IRC) suggested guidelines for Comprehensive Cardiopulmonary Life Support (CCLS) for suspected or confirmed coronavirus disease (COVID-19) patient. Indian J Anaesth 2020; 64:S91-S96. [PMID: 32773845 PMCID: PMC7293361 DOI: 10.4103/ija.ija_481_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/01/2020] [Accepted: 05/09/2020] [Indexed: 02/07/2023] Open
Abstract
Management of the recent outbreak of the novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) remains challenging. The challenges are not only limited to its preventive strategies, but also extend to curative treatment, and are amplified during the management of critically ill patients with COVID-19. Older persons with comorbidities like diabetes mellitus, cardiac diseases, hepatic impairment, renal disorders and respiratory pathologies or immune impairing conditions are more vulnerable and have a higher mortality from COVID-19. Earlier, the Indian Resuscitation Council (IRC) had proposed the Comprehensive Cardiopulmonary Life Support (CCLS) for management of cardiac arrest victims in the hospital setting. However, in patients with COVID-19, the guidelines need to be modified,due to various concerns like differing etiology of cardiac arrest, virulence of the virus, risk of its transmission to rescuers, and the need to avoid or minimize aerosolization from the patient due to various interventions. There is limited evidence in these patients, as the SARS-CoV-2 is a novel infection and not much literature is available with high-level evidence related to CPR in patients of COVID-19. These suggested guidelines are a continuum of CCLS guidelines by IRC with an emphasis on the various challenges and concerns being faced during the resuscitative management of COVID-19 patients with cardiopulmonary arrest.
Collapse
Affiliation(s)
- Baljit Singh
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India
| | - Rakesh Garg
- Department of Onco-Anaesthesia and Palliative Medicine, Dr BRAIRCH, AIIMS, New Delhi, India
| | | | - Syed M Ahmed
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - J V Divatia
- Department of Emergency Medicine, SRMC, Porur, Chennai, Tamil Nadu, India
| | - T V Ramakrishnan
- Department of Anaesthesiology and Critical Care, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Lalit Mehdiratta
- Department of Anaesthesiology and Critical Care, Narmada Trauma Center, Bhopal, Madhya Pradesh, India
| | - Muralidhar Joshi
- Chief Anaesthesiologist, Viranchi Hospital, Hyderabad, Telangana, India
| | - Naveen Malhotra
- Department of Anaesthesiology, Pain and Critical Care, PGIMS, Rohtak, Haryana, India
| | | |
Collapse
|
7
|
Kapoor MC, Ahmed SM, Garg R. Indian resuscitation council cardiopulmonary resuscitation guidelines: The way ahead! Indian J Anaesth 2018; 62:924-925. [PMID: 30532340 PMCID: PMC6236781 DOI: 10.4103/ija.ija_646_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mukul C Kapoor
- Department of Anaesthesia, Max Smart Super Specialty Hospital, Press Enclave Road, Saket, New Delhi, India
| | - Syed Moied Ahmed
- Department of Anaesthesiology and Critical Care, J N Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rakesh Garg
- Department of Onco-Anaesthesiology and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
8
|
Abstract
Pregnancy is a normal physiologic process with the potential for pathologic states. Pregnancy has several unique characteristics including an utero-placental interface, a physiologic stress that can cause pathologic states to develop, and a maternal–foetal interface that can affect two lives simultaneously or in isolation. Critical illness in pregnant women may result from deteriorating preexisting conditions, diseases that are co-incidental to pregnancy, or pregnancy-specific conditions. Successful maternal and neonatal outcomes for parturients admitted to a maternal critical care facility are largely dependent on a multidisciplinary input to medical or surgical condition from critical care physicians, obstetric anaesthesiologists, obstetricians, obstetric physicians, foetal medicine specialists, neonatologists, and concerned specialists. Pregnant women requiring maternal critical care unit admission are relatively low in developed nations and range from 0.9% to 1%; but in our country, the admission rates of critically ill parturients range from 3% to 8%. Two-thirds of pregnant women requiring critical care are often unanticipated at the time of conception. In this review, we will look at critical illnesses in pregnant women with a specific focus on pregnancy-induced illnesses.
Collapse
Affiliation(s)
- Sunil T Pandya
- Department of Anaesthesia, Pain Medicine and Surgical and Obstetric Critical Care, Century Hospital, Hyderabad, Telangana, India.,Department of Anaesthesia, Pain Medicine and Obstetric Critical Care, Fernandez Hospital, Hyderabad, Telangana, India.,Prerna Anaesthesia and Critical Care Services Pvt Ltd., Hyderabad, Telangana, India
| | - Kiran Mangalampally
- Department of Anaesthesia, Pain Medicine and Surgical and Obstetric Critical Care, Century Hospital, Hyderabad, Telangana, India
| |
Collapse
|
9
|
Pahade A, Chawla R, Shah SB, Bhargava AK. Implementation of Indian Society of Anesthesiologists' cardiopulmonary resuscitation guidelines: A bumpy road ahead? Indian J Anaesth 2018; 62:919-921. [PMID: 30532338 PMCID: PMC6236787 DOI: 10.4103/ija.ija_142_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Akhilesh Pahade
- Department of Anesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Rajiv Chawla
- Department of Anesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Shagun B Shah
- Department of Anesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - A K Bhargava
- Department of Anesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| |
Collapse
|
10
|
Pareek M, Parmar V, Badheka J, Lodh N. Study of the impact of training of registered nurses in cardiopulmonary resuscitation in a tertiary care centre on patient mortality. Indian J Anaesth 2018; 62:381-384. [PMID: 29910497 PMCID: PMC5971628 DOI: 10.4103/ija.ija_17_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills to be able to implement effective interventions during in-hospital cardiac arrest. The aim of this descriptive study was to assess mortality impact after nurses' CPR training with pre-CPR training data at our institute. Methods: Training regarding CPR was given to nurses, and CPR mortality 1-year before basic life support (BLS) and advanced cardiac life support (ACLS) training were collected and compared with post-training 1-year CPR mortality. Results: A total of 632 adult patients suffering in-hospital cardiac arrest over the study period. CPR was attempted in 294 patients during the pre-BLS/ACLS training period and in 338 patients in the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 58 patients (19.7%) had return of spontaneous circulation (ROSC), while during the post-BLS/ACLS training period, 102 patients (30.1%) had ROSC (P = 0.003). Sixteen of the 58 patients (27.5%) who achieved ROSC during the pre-BLS/ACLS training period survived to hospital discharge, compared 54 out of 102 patients (52.9%) in the post-BLS/ACLS training period (P < 0.0001). There was no significant association between either the age or sex with the outcomes in the study. Conclusion: Training nurses in cardiopulmonary resuscitation resulted in a significant improvement in survival to hospital discharge after in-hospital cardiac arrest.
Collapse
Affiliation(s)
- Mayureshkumar Pareek
- Department of Anaesthesiology, P. D. U. Government Medical College, Rajkot, Gujarat, India
| | - Vandana Parmar
- Department of Anaesthesiology, P. D. U. Government Medical College, Rajkot, Gujarat, India
| | - Jigisha Badheka
- Department of Anaesthesiology, P. D. U. Government Medical College, Rajkot, Gujarat, India
| | - Nirmalyo Lodh
- Department of Anaesthesiology, P. D. U. Government Medical College, Rajkot, Gujarat, India
| |
Collapse
|
11
|
Trichur RV. Need for resuscitation registry in India based on Indian Society of Anaesthesiologists cardiopulmonary resuscitation guidelines. Indian J Anaesth 2017; 61:895-896. [PMID: 29217854 PMCID: PMC5703002 DOI: 10.4103/ija.ija_680_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ramakrishnan V Trichur
- Department of Emergency Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| |
Collapse
|