Cardiopulmonary resuscitation in critically ill neurologic-neurosurgical patients

Alejandro A. Rabinstein, Robyn L. McClelland, Eelco F.M. Wijdicks, Edward M. Manno, John L.D. Atkinson

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

OBJECTIVES: To establish the rate of successful cardiopulmonary resuscitation (CPR) and to study outcome predictors in patients who experienced in-hospltal cardiac arrest after being admitted to the neurologic-neurosurgical intensive care unit (ICU) with a primary neurologic diagnosis. PATIENTS AND METHODS: We identified patients admitted to the neurologic-neyrosurgical ICU between 1994 and 2001 who experienced in-hospital cardiac arrest and received CPR. Functional outcome was assessed using the modified Rankin scale. RESULTS: During the study period, 38 consecutive patients experienced in-hospital cardiac arrest and received CPR. The median age of the patients was 65 years (range, 16-81 years), and the mean interval from admission to CPR was 12 days (range, 3 hours to 47 days). Acute intracranial disease was present in 32 patients (84%). Twenty-one patients (55%) were in the ICU at the time of the cardiac artest; cardiac arrests in the wards occurred at a mean interval of 9 days (range, 1-45 days) after ICU discharge. Cardiopulmonary resuscitation achieved return of spontaneous circulation in 23 patients (61%). Seven patients (18%) were discharged from the hospital, 5 of whom later achieved a modified Rankin scale score of 2 or lower. Cardiac arrest after a deteriorating clinical course resulted in uniformly fatal outcomes. Duration of CPR shorter than 5 minutes and CPR in the ICU were associated with survival and good functional recovery. CONCLUSIONS: Cardiopulmonary resuscitation is a worthwhile procedure in severely III neurologic-neurosurgical patients, regard-less of the patient's age. However, the outcome after CPR appears much worse in patients with a prior deteriorating clinical course.

Original languageEnglish (US)
Pages (from-to)1391-1395
Number of pages5
JournalMayo Clinic proceedings
Volume79
Issue number11
DOIs
StatePublished - Nov 2004

ASJC Scopus subject areas

  • Medicine(all)

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    Rabinstein, A. A., McClelland, R. L., Wijdicks, E. F. M., Manno, E. M., & Atkinson, J. L. D. (2004). Cardiopulmonary resuscitation in critically ill neurologic-neurosurgical patients. Mayo Clinic proceedings, 79(11), 1391-1395. https://doi.org/10.4065/79.11.1391