Abstract
Objectives: Data reporting outcomes of patients needing cardiopulmonary resuscitation (CPR) after cardiac surgery during their primary hospital stay are scarce. The present study evaluated (1) reasons for CPR, (2) immediate and (3) further outcomes after CPR. Methods: In 2007 and 2008, a total of 4021 patients underwent any cardiac surgery. Out of these, 129 patients (3.2%) needed CPR during their primary hospital stay. Further hospital and post-hospital outcome was retrospectively analysed. The patients were predominantly male (61.5%), with average age 70.9 ± 9.9 years. Mean follow-up was 56.0 ± 149.2 days, ranging up to 878 days. Results: Surgery consisted of isolated aortic valve replacement (35.2%), isolated coronary artery bypass graft (CABG) (31.3%) and AV-valve surgery (30.0%). Further procedures were combined aortic valve replacement (AVR)/CABG (2.5%) and ventricular sept defect (VSD)-closure (1.3%). CPR took place after a median of 3.5 days after surgery with a mean duration of 21.1 ± 19.3 min. Neuroprotective hypothermia (32°C for 24 h) was established in 22.2% of the patients. Reasons for CPR were rhythm-disturbances (67.1%), low cardiac output (27.5%) and respiratory failure (5.4%). CPR was primary successful in 69.5%, but subsequently a further 58.9% died, equalling an overall mortality of 71.3%. Morbidity after CPR consisted of neurologic deficit (12.2%), airway infection (28.1%), impaired wound healing (13.3%) and renal failure (41.8%). Mean ventilation time after CPR was 68.8 ± 192.4 h, ICU-stay averaged 2.5 ± 7.2 days. Conclusion: Despite immediate results after CPR being characterised by a high initial success rate, consecutive secondary morbidity subsequently causes discouragingly high mortality during further follow-up. Additionally, significant demands on hospital resources are made. The only effective strategy is prevention of CPR. Most observed reasons could be influenced positively by simple prevention strategies.
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