Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status

David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M. Caroline Burton

Research output: Contribution to journalArticle

Abstract

Introduction: Guidelines recommend discussing code status with patients on hospital admission. No study has evaluated the feasibility of a full code with do not intubate (DNI) status. Methods: A retrospective analysis of patients who experienced a cardiopulmonary arrest was performed between May 1, 2008 and June 20, 2014. A descriptive analysis was created based on whether patients required mechanical ventilatory support during the hospitalization and comparisons were made between both patient subsets. Results: A total of 239 patients were included. Almost all (n = 218, 91.2%) required intubation during the hospitalization. Over half (n = 117, 53.7%) were intubated on the same day as the cardiopulmonary arrest and 91 patients (41.7%) were intubated at the time of arrest. Comparisons between intubated and non-intubated patients showed little differences in clinical characteristics, except for a higher proportion of medical cardiac etiology for admission in patients who did not require intubation (n = 10, 47.6% versus n = 55, 25.2%; p = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; p = 0.37). No differences in 24-hour and posthospital survivals were present. Conclusion: Mechanical ventilatory support is commonly utilized in patients who experience a cardiopulmonary arrest. The DNI status may not be a feasible code status option for most patients.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAcute Cardiac Care
DOIs
StateAccepted/In press - Dec 7 2017

Keywords

  • do not intubate
  • do not resuscitate
  • full code
  • Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Snipelisky, D., Dumitrascu, A., Ray, J., Roy, A., Matcha, G., Harris, D., Vadeboncoeur, T., Kusumoto, F., & Burton, M. C. (Accepted/In press). Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status. Acute Cardiac Care, 1-6. https://doi.org/10.1080/17482941.2017.1408917