CAO Recovered in the General Intensive Care Unit: Epidemioclinical Characteristics and Mortality Factors in a Sub-Saharan African Country

Abstract

Background: Cardiac arrest in the operating room (CAO) is a serious accident of often rare epidemiology.
 Methods: Retrospective, descriptive and analytical study from 2012 to 2021 in the multipurpose intensive care unit of the Cocody University Hospital in Abidjan, including all patients who presented a recovered CAO.
 Results: The prevalence was 1.5% (89 out of 5730 admissions). The mean age was 33.5 ± 26 years (13-81). The sex ratio was 0.1. The medical history was mostly hypertension (22.5%). Patients were classified ASA ≥ III (52.8%) for urgent surgery (52.8%) under spinal anesthesia (56.6%). CAO occurred mostly at anesthetic induction (44.3%). The causes were mainly persistent arterial hypotension (54.7%) and hemorrhagic shock (30.2%). Medical CPR was performed in 94.8% of cases in the operating room before transfer to the intensive care unit. The mean duration of LowFlow was 4.5±1.8 minutes (3-12). On admission, the mean Glasgow score was 6.3±4.4 (3-11). Treatment consisted of continued CPR. The mean stay was 3.1±2.9 minutes (1-12). The death rate was 60.4%. ASA class >3, urgent procedure, general anesthesia, presence of NA alone, Gl score ≤ 7, and Low Flow duration> 5 minutes were predictive of mortality (p < 0.05).
 Conclusion: strengthening of material resources and continuous training in extreme emergency situations for anesthesia personnel could optimize the prognosis of CAO.