Table 4.
Survival and neurological follow-up of the patients with intraoperative cardiac arrest.
| All patients | Adults (≥16 yrs) | Children (<16 yrs) | p | |
|---|---|---|---|---|
| Return of spontaneous circulation (ROSC) | ||||
| ROSC | 163/195 (83.6, 77.6–88.5%) | 158/188 (84.0, 78.0–89.0%) | 5/7 (71.4, 29.0–96.3%) | 0.32 |
| Reason no ROSC | 0.13 | |||
| ECPR | 12/32 (37.5%) | 10/30 (33.3%) | 2/2 (100%) | |
| Death | 20/32 (62.5%) | 20/30 (66.7%) | 0/2 (0.00%) | |
| Death after ECPR | 10/12 (83.3%) | 9/10 (90.0%) | 1/2 (50.0%) | 0.32 |
| Actions after ROSC | ||||
| Intubation | 15/163 (9.2%) | 15/158 (9.5%) | 0/5 (0%) | >0.99 |
| Pacemaker insertion | 3/163 (1.8%) | 3/158 (1.9%) | 0/5 (0%) | >0.99 |
| Percutaneous coronary intervention | 3/163 (1.8%) | 3/158 (1.9%) | 0/5 (0%) | >0.99 |
| Lysis | 2/163 (1.2%) | 2/158 (1.3%) | 0/5 (0%) | >0.99 |
| ECLS | 9/163 (5.5%) | 8/158 (5.1%) | 1/5 (20.0%) | 0.25 |
| Other1 | 122/163 (74.8%) | 117/158 (74.1%) | 5/5 (100%) | 0.33 |
| Sustained ROSC | ||||
| Sustained ROSC over 20 min | 147/163 (90.2%) | 143/158 (90.5%) | 4/5 (80.0%) | 0.41 |
| Condition with sustained ROSC | ||||
| Awake | 10/163 (6.1%) | 10/158 (6.3%) | 0/5 (0%) | >0.99 |
| Sedated | 144/163 (88.3%) | 139/158 (88.0%) | 5/5 (100%) | >0.99 |
| Coma | 7/163 (4.3%) | 7/158 (4.4%) | 0/5 (0%) | >0.99 |
| Controlled ventilation | 149/163 (91.4%) | 144/158 (91.1%) | 5/5 (100%) | >0.99 |
| Assisted ventilation | 1/163 (0.6%) | 1/158 (0.6%) | 0/5 (0%) | >0.99 |
| Spontaneous breathing | 7/163 (4.3%) | 7/158 (4.4%) | 0/5 (0%) | >0.99 |
| Vasopressors2 | 127/163 (77.9%) | 124/158 (78.5%) | 3/5 (60.0%) | 0.31 |
| Transfer after sustained ROSC | 0.56 | |||
| Post-anesthesia Care Unit | 17/160 (10.6%) | 16/155 (10.3%) | 1/5 (20.0%) | |
| Intermediate Care Unit | 18/160 (11.2%) | 18/155 (11.6%) | 0/5 (0.00%) | |
| Intensive Care Unit | 122/160 (76.2%) | 118/155 (76.1%) | 4/5 (80.0%) | |
| Cardiac Catheterization Laboratory | 3/160 (1.88%) | 3/155 (1.9%) | 0/5 (0.00%) | |
| Survival outcome 30 days | ||||
| Survival 30 days of those with ROSC | 111/163 (68.1, 60.4–75.2%) | 106/158 (67.1, 59.2–74.3%) | 5/5 (100, 47.8–100%) | 0.18 |
| Survival 30 days of all patients | 111/195 (56.9, 49.7–64.0%) | 106/188 (56.4, 49.0–63.6%) | 5/7 (71.4, 29.0–96.3%) | 0.70 |
| CPC (30 days): | – | |||
| 1 | – | 63/106 (59.4, 49.5–68.9%) | 3/5 (60.0, 14.7–94.7%) | |
| 2 | – | 27/106 (25.5, 17.5–34.9%) | 1/5 (20.0, 0.5–71.6%) | |
| 3 | – | 16/106 (15.1, 8.9–23.4%) | 1/5 (20.0, 0.5–71.6%) | |
| Survival outcome 3 months | ||||
| Survival 3 months of those with ROSC | 107/163 (65.6, 57.8–72.9%) | 103/158 (65.2, 57.2–72.6%) | 4/5 (80.0, 28.4–99.5%) | |
| Survival 3 months of all patients | 107/195 (54.9, 47.6–62.0%) | 103/188 (54.8, 47.4–62.0%) | 4/7 (57.1%, 18.4–90.1%) | |
| Participated at follow-up | 39/67 | 3/5 | ||
| CPC (3 months): | ||||
| 1 | – | 34/39 (87.2, 72.6–95.7%) | 2/3 (66.7, 9.4–99.2%) | |
| 2 | – | 4/39 (10.3, 2.9–24.2%) | 1/3 (33.3, 0.8–90.6%) | |
| 3 | – | 1/39 (2.6, 0.1–13.5%) | 0/3 (0, 0.0–70.8%) | |
| 12-item Short Form Survey (3 months) | ||||
| Physical component score | 43.5 (40.2–46.8) | 43.3 (39.9–46.8) | 45.7 (14.6–76.8) | 0.78 |
| Mental component score | 50.9 (47.6–54.1) | 51.0 (47.6–54.4) | 49.1 (30.1–68.2) | 0.73 |
ROSC, return of spontaneous circulation; ECPR, extracorporeal cardiopulmonary resuscitation; ECLS, extracorporeal life support; CPC, clinical performance category.
1
Routine critical care investigations including blood gas test, blood tests, X-Ray, 12-lead electrocardiogram.
2
Routine post-resuscitation care to maintain hemodynamic stability, including continuous vasopressors infusion with syringe pumps (e.g., Epinephrine or Norepinephrine).