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 language | English (US) |
|---|---|
| Pages (from-to) | 938-942 |
| Number of pages | 5 |
| Journal | Resuscitation |
| Volume | 81 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2010 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Incidence of re-arrest and critical events during prolonged transport of post-cardiac arrest patients
AU - Hartke, A.
AU - Mumma, Bryn
AU - Rittenberger, J. C.
AU - Callaway, C. W.
AU - Guyette, F. X.
PY - 2010/8
Y1 - 2010/8
N2 - 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.
AB - 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.
KW - Cardiac arrest
KW - EMS
KW - Helicopter
KW - Hypothermia
KW - Resuscitation
UR - http://www.scopus.com/inward/record.url?scp=77954758382&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954758382&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2010.04.012
DO - 10.1016/j.resuscitation.2010.04.012
M3 - Article
C2 - 20483520
AN - SCOPUS:77954758382
VL - 81
SP - 938
EP - 942
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
IS - 8
ER -