Cardiopulmonary arrest after cardiac surgery: A retrospective cohort of 142 patients with nine year follow up

Abstract

BackgroundAlthough the techniques and perioperative management in modern cardiac surgeries has improved, and mortality and morbidity have decreased dramatically, postoperative cardiac arrest after heart surgery (POCHS) is a life-threatening condition that should be assessed and managed precisely. ObjectiveTo determine the mortality rate and causes of death in postoperative cardiac arrest after heart surgery (POCHS). MethodsA total of 3342 patients underwent cardiac surgery from 2010 to 2018 in Isfahan, Iran .142 of them experienced POCHS . POCHS patients were investigated for characteristics, causes of cardiopulmonary arrest, first-line treatment, and mortality. These items were compared between survived and deceased patients to find possible prognostic factors. ResultsThe incidence rate of cardiac arrest was 4.2% (142 ones from total of 3342). Success rate of cardiac arrest is 28.8% (41 from 142). Bradycardia was the most common cause of cardiorespiratory arrest (37.3%), followed by cardiogenic shock (30.3%) and ventricular fibrillation (23.2%). Younger patients (58±11.5 versus 62.9±11.3) and those who developed cardiopulmonary arrest due to ventricular fibrillation (42.4% versus 22.2%), bradycardia (21.2% versus 8.8%), and apnea (15.1% versus 6.6%) were more likely to survive, while, those with shock had the worst prognosis (P<0.05). The best response to resuscitation was found among those treated with defibrillator plus ECM (External Cardiac Massage) as compared to the other approaches (P-value=0.003). ConclusionBased on the current report, CPR success was found in 28.6% among whom respiratory etiology led to better outcomes than cardiac etiology. The second cause of cardiac arrest is ventricular fibrillation which immediate defibrillation has the best outcome. The highest numerical success in POCHS is combination of ECM with defibrillator.