Incidence of re-arrest and critical events during prolonged transport of post-cardiac arrest patients

A. Hartke, Bryn Mumma, J. C. Rittenberger, C. W. Callaway, F. X. Guyette

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Aim: To determine the feasibility of transporting post-cardiac arrest patients to tertiary-care facilities, the rate of re-arrest, and the rate of critical events during critical care transport team (CCTT) care. Methods: Retrospective chart review of cardiac arrest patients transported via CCTT between 1/1/2001 and 5/31/2009. Demographic information, re-arrest, and critical events during transport were abstracted. We defined critical events as hypotension (systolic blood pressure < 90mm. Hg), hypoxia (oxygen saturation < 90%), or both hypotension and hypoxia at any time during CCTT care. Comparisons were performed using Chi-squared test and a Cox proportional hazards model was employed to determine predictors of events. Results: Of the 248 patients studied, the majority was male (61%), presented in ventricular fibrillation or ventricular tachycardia (VF/VT, 50%), and comatose (80%). Re-arrest was uncommon (N= 15; 6%). Critical events affected 58 patients (23%) during transport. Median transport time was 63. min (IQR 51, 81) in both those who experienced a critical event and those who did not. Vasopressor use was associated with any decompensation during CCTT (Hazard Ratio 1.81; 95%CI 1.29, 2.54). Three patients (20%) suffering re-arrest survived to hospital discharge. Survival (Chi square 11.77; p< 0.01) and good neurologic outcome (Chi square 5.93; p= 0.01) were higher in patients who did not suffer any event during transport. Conclusions: Transport of resuscitated cardiac arrest patients to a tertiary-care facility via CCTT is feasible, and the duration of transport is not associated with re-arrest during transport. Repeat cardiac arrest occurs infrequently, while critical events are more common. Outcomes are worse in those experiencing an event.

Original languageEnglish (US)
Pages (from-to)938-942
Number of pages5
JournalResuscitation
Volume81
Issue number8
DOIs
StatePublished - Aug 2010
Externally publishedYes

Fingerprint

Heart Arrest
Critical Care
Incidence
Tertiary Healthcare
Hypotension
Blood Pressure
Ventricular Fibrillation
Ventricular Tachycardia
Coma
Proportional Hazards Models
Nervous System
Demography
Oxygen
Survival

Keywords

  • Cardiac arrest
  • EMS
  • Helicopter
  • Hypothermia
  • Resuscitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine
  • Medicine(all)

Cite this

Incidence of re-arrest and critical events during prolonged transport of post-cardiac arrest patients. / Hartke, A.; Mumma, Bryn; Rittenberger, J. C.; Callaway, C. W.; Guyette, F. X.

In: Resuscitation, Vol. 81, No. 8, 08.2010, p. 938-942.

Research output: Contribution to journalArticle

Hartke, A. ; Mumma, Bryn ; Rittenberger, J. C. ; Callaway, C. W. ; Guyette, F. X. / Incidence of re-arrest and critical events during prolonged transport of post-cardiac arrest patients. In: Resuscitation. 2010 ; Vol. 81, No. 8. pp. 938-942.
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abstract = "Aim: To determine the feasibility of transporting post-cardiac arrest patients to tertiary-care facilities, the rate of re-arrest, and the rate of critical events during critical care transport team (CCTT) care. Methods: Retrospective chart review of cardiac arrest patients transported via CCTT between 1/1/2001 and 5/31/2009. Demographic information, re-arrest, and critical events during transport were abstracted. We defined critical events as hypotension (systolic blood pressure < 90mm. Hg), hypoxia (oxygen saturation < 90{\%}), or both hypotension and hypoxia at any time during CCTT care. Comparisons were performed using Chi-squared test and a Cox proportional hazards model was employed to determine predictors of events. Results: Of the 248 patients studied, the majority was male (61{\%}), presented in ventricular fibrillation or ventricular tachycardia (VF/VT, 50{\%}), and comatose (80{\%}). Re-arrest was uncommon (N= 15; 6{\%}). Critical events affected 58 patients (23{\%}) during transport. Median transport time was 63. min (IQR 51, 81) in both those who experienced a critical event and those who did not. Vasopressor use was associated with any decompensation during CCTT (Hazard Ratio 1.81; 95{\%}CI 1.29, 2.54). Three patients (20{\%}) suffering re-arrest survived to hospital discharge. Survival (Chi square 11.77; p< 0.01) and good neurologic outcome (Chi square 5.93; p= 0.01) were higher in patients who did not suffer any event during transport. Conclusions: Transport of resuscitated cardiac arrest patients to a tertiary-care facility via CCTT is feasible, and the duration of transport is not associated with re-arrest during transport. Repeat cardiac arrest occurs infrequently, while critical events are more common. Outcomes are worse in those experiencing an event.",
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AU - Guyette, F. X.

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KW - Resuscitation

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