Cardiac arrest in adult intensive care units in the Medellin metropolitan area, Colombia: observational study

  • Juan Carlos Villa-Velásquez Anesthesia and Resuscitation Section, Medical School, Universidad de Antioquia, Medellín, Colombia
  • Natalia Andrea Hoyos-Vanegas IPS Universitaria, Universidad de Antioquia, Medellín, Colombia
  • Juan Carlos Gómez-Echeverry IPS Universitaria, Universidad de Antioquia, Medellín, Colombia
  • Airton Payares-Benítez IPS Universitaria, Universidad de Antioquia, Medellín, Colombia
  • Fabián David Casas-Arroyave a. Anesthesia and Resuscitation Section, Medical School, Universidad de Antioquia, Medellín, Colombia. b. Anesthesia and Resuscitation Section, Hospital Universitario San Vicente Fundación, Medellín, Colombia
Keywords: Cardiac arrest, Intensive unit, Cardiac resuscitation, Mortality

Abstract

Introduction: In-hospital cardiac arrest (CA) is a rare but lifethreatening event. However, the epidemiology of this event in intensive care units (ICU) is not clear.

Objective: To determine the clinical characteristics of CA in adult patients hospitalized in several ICU of the Metropolitan Area of the Aburrá Valley, Colombia, over a period of 1 year.

Methods: Observational study for a limited period of 1 year for adult patients with CA in the ICU of the hospitals of the Metropolitan Area of the Aburrá Valley, Colombia: San Vicente Foundation University Hospital, IPS University, and Manuel Uribe Ángel Hospital.

Results: Of 3710 eligible patientswhowere treated in 91 beds, 646 CA events occurred during this period, of which 151 were candidates for resuscitation maneuvers. The overall incidence of CA in the ICU was 17.1%, without differences between the 3 hospitals included and the incidence of resuscitable CA was 39.9 cases per 1000 admissions to the ICU. The most common CA rhythm was asystole (54.3%) and the overall survival at hospital discharge was 3.3%.

Conclusion: In the analyzed ICU, CA was an infrequent event, but it presents a high mortality at discharge from the ICU and hospital. However, the few patients who survive have a good neurological prognosis.

References

Efendijev I, Nurmi J, Castrén M, et al. Incidence and outcome from adult cardiac arrest occurring in the intensive care unit: a systematic review of the literature. Resuscitation 2014;85:472–479.

Navarro VJR. Registry of cardiac arrest in adults. Rev Fac Med 2005;53:196–203.

Cogollo Mejía DA, Londoño Cano V, Toro González JE, Fernandez Restrepo JJ, Patiño Restrepo C. Review of international, national and local cases of prehospital care of cardio-respiratory arrest with and without an automatic external defibrillator. [Internet]. Medellín: Editorial Universidad CES; 2010 [cited 2020 May 14]. Available at: http://wap.smshungama.in/handle/10946/2783.

Hincapie C, Ricunque D. Tablas abreviadas de mortalidad nacional 1985–2020. 2017;DANE, 3. https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/series-de-poblacion.

Valencia W, Navarro JR, Ramírez K, et al. Implementation of a Cardiopulmonary Arrest Registry in a Secondary-level Hospital. Colombian Journal of Anesthesiology 2012;39:478–487.

Chen LM, Nallamothu BK, Spertus JA, et al. Association between a hospital rate of cardiac arrest incidence and cardiac arrest survival. JAMA Intern Med 2013;173:1186–1195.

Fredriksson M, Aune S, Bång A, et al. Cardiac arrest outside and inside hospital in a community. Mechanisms behind the differences in outcome and outcome in relation to time of arrest. Am Heart J 2010;159:749–756.

Redpath C, Sambell C, Stiell I, et al. In-hospital mortality in 13,263 survivors of out-of-hospital cardiac arrest in Canada. Am Heart J 2010;159:577–583.

Wallace S, Ewer MS, Price KJ, et al. Outcome and cost implications of cardiopulmonary resuscitation in the medical intensive care unit of a comprehensive cancer center. Support Care Cancer 2002;10:425–429.

De-la-Chica R, Colmenero M, Chavero MJ, et al. Prognostic factors of mortality in a cohort of patients with hospital cardiorespiratory arrest. Med Intensiva 2010;34:161–169.

Efendijev I, Raj R, Reinikainen M, et al. Temporal trends in cardiac arrest incidence and outcome in Finnish intensive care units from 2003 to 2013. Intensive Care Med 2014;40:1853–1861.

Skrifvars MB, Varghese B, Parr MJ. Survival and outcome prediction using the Apache III and the out-of-hospital cardiac arrest (OHCA) score in patients treated in the intensive care unit (ICU) following out-of-hospital, in-hospital or ICU cardiac arrest. Resuscitation 2012;83:728–733.

Callaway CW, Donnino MW, Fink EL, et al. Post-cardiac arrest care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132 (18suppl2):S465–S482.

How to Cite
Villa-Velásquez, J. C., Hoyos-Vanegas, N. A., Gómez-Echeverry, J. C., Payares-Benítez, A., & Casas-Arroyave, F. D. (2020). Cardiac arrest in adult intensive care units in the Medellin metropolitan area, Colombia: observational study. Colombian Journal of Anesthesiology, 48(3), 118-125. Retrieved from https://www.revcolanest.com.co/index.php/rca/article/view/901

Downloads

Download data is not yet available.
Published
2020-07-01
How to Cite
Villa-Velásquez, J. C., Hoyos-Vanegas, N. A., Gómez-Echeverry, J. C., Payares-Benítez, A., & Casas-Arroyave, F. D. (2020). Cardiac arrest in adult intensive care units in the Medellin metropolitan area, Colombia: observational study. Colombian Journal of Anesthesiology, 48(3), 118-125. Retrieved from https://www.revcolanest.com.co/index.php/rca/article/view/901
Section
Original Article