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:
- Unwitnessed cardiac arrest – delay in initiation of cardiopulmonary resuscitation likely to be high.
- 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.
- 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.
- Ongoing CPR – no return of spontaneous circulation yet
- Took more than 30 minutes of resuscitation for return of spontaneous circulation
- Severe acidosis with pH less than 7.2
- Lactate levels above 7 millimoles per liter
- Age above 85 years
- End stage renal disease
- Non cardiac causes like trauma causing cardiac arrest
Reference
- 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.