Features indicating unfavourable outcome after cardiopulmonary resuscitation (CPR)

Features indicating unfavourable outcome after cardiopulmonary resuscitation (CPR) in out of hospital cardiac arrest

Features indicating unfavourable outcome after cardiopulmonary resuscitation in out of hospital cardiac arrest:

1. Unwitnessed cardiac arrest – delay in initiation of cardiopulmonary resuscitation likely to be high.
2. Initial cardiac rhythm other than ventricular fibrillation – meaning that it is a non shockable rhythm. May also indicate that there has been a delay after the onset of cardiac arrest and monitoring so that an initial shockable rhythm has deteriorated into a non shockable rhythm.
3. No bystander CPR has been received – indicates likelihood of more cerebral anoxia and poor outcome after resuscitation even if return of spontaneous circulation (ROSC) is achieved.
4. Ongoing CPR – no return of spontaneous circulation yet
5. Took more than 30 minutes of resuscitation for return of spontaneous circulation
6. Severe acidosis with pH less than 7.2
7. Lactate levels above 7 millimoles per liter
8. Age above 85 years
9. End stage renal disease
10. Non cardiac causes like trauma causing cardiac arrest

Reference

1. Rab T, Kern KB, Tamis-Holland JE, Henry TD, McDaniel M, Dickert NW, Cigarroa JE, Keadey M, Ramee S; Interventional Council, American College of Cardiology. Cardiac Arrest: A Treatment Algorithm for Emergent Invasive Cardiac Procedures in the Resuscitated Comatose Patient. J Am Coll Cardiol. 2015;66(1):62-73.