by Jonathan Chelly, Gaetan Plantefève, Toufik Kamel, Cédric
Bruel, Saad Nseir, Christopher Lai, Giulia Cirillo, Elena Skripkina, Sébastien
Ehrminger, Fernando-Daniel Berdaguer-Ferrari, Julien Le Marec, Marine Paul,
Aurélie Autret and Nicolas Deye
Annals of
Intensive Care volume 11,
Article number: 155 (2021)
Background
Initial reports have described the poor outcome of
unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19
patients in China and the USA. However, there are scarce data on characteristics
and outcomes of such CA patients in Europe.
Methods
Prospective registry in 35 French ICUs, including all in-ICU
CA in COVID-19 adult patients with cardiopulmonary resuscitation (CPR) attempt.
Favorable outcome was defined as modified Rankin scale ranging from 0 to 3 at
day 90 after CA.
Results
Among the 2425 COVID-19 patients admitted to ICU from March
to June 2020, 186 (8%) experienced in-ICU CA, of whom 146/186 (78%) received
CPR. Among these 146 patients, 117 (80%) had sustained return of spontaneous
circulation, 102 (70%) died in the ICU, including 48 dying within the first day
after CA occurrence and 21 after withdrawal of life-sustaining therapy. Most of
CA were non-shockable rhythm (90%). At CA occurrence, 132 patients (90%) were
mechanically ventilated, 83 (57%) received vasopressors and 75 (51%) had almost
three organ failures. Thirty patients (21%) had a favorable outcome.
Sepsis-related organ failure assessment score > 9 before CA occurrence was
the single parameter constantly associated with unfavorable outcome in
multivariate analysis.
Conclusions
In-ICU CA incidence remains high among a large multicenter
cohort of French critically ill adults with COVID-19. However, 21% of patients
with CPR attempt remained alive at 3 months with good functional status.
This contrasts with other recent reports showing poor outcome in such patients.
No comments:
Post a Comment