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786 DR MASHOOQUE ALI DASTI MD CARDIOLOGY

786 DR MASHOOQUE ALI DASTI MD CARDIOLOGY. Introduction. At least 350 000 people will suffer cardiac arrest each year in the United States, 1 every 90 seconds.

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786 DR MASHOOQUE ALI DASTI MD CARDIOLOGY

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  1. 786DR MASHOOQUE ALI DASTI MD CARDIOLOGY

  2. Introduction At least 350 000 people will suffer cardiac arrest each yearin the United States, 1 every 90 seconds. Many will then undergocardiopulmonary resuscitation (CPR) by bystanders and emergencymedical services in a desperate attempt to restore life. Numerousstudies report that the majority of these efforts will not succeed. Prolonged anoxia, the inability to restore spontaneous circulation,neurological devastation, and other complications combine tolimit survival. It is a young science; theterm "CPR" was first publicized less than 50 years ago

  3. . Dr Claude Beck and his first cardiac defibrillator. Images courtesy of Dr Igor Efimov (left) and the Dittrick Medical History Center, Case Western Reserve University (right).

  4. Statistics of Survival Modern published studies of resuscitation for cardiac arrest(all cardiac rhythms) show rates of survival to hospital dischargethat range from 1% to 25% for outpatients and0% to 29% for inpatients. Of the first 20 patients who underwent closed-chest cardiacmassage, only 3 had ventricular fibrillation, and yet 14 survivedthe arrest (70% survival). In 1953, a review of 1200 in-hospitalcardiac arrests reported that, despite only 11% having ventricularfibrillation, 28% were resuscitated to "permanent survival.“

  5. OUTCOME OF CADIOPULMONARY RESUSCITATION AFTER MYOCARDIAL INFARCTION AT DEWAN MUSHTAQUE • AIMS OF STUDY • The purpose of this study was to evaluate in hospital survival of the patients with myocardial infarction who developed cardiac arrest and to look into the factors associated with success rate of CPR.

  6. BACKGROUND The major determinants of survival after in-Hospital cardiac arrest depend upon The time factors, How quickly it is initiated, Extent of resuscitation efforts, Expertness of team Dedication of CPR team.

  7. METHOD • Prospective study of 126 patients admitted in DEWAN MUSHTAQUE coronary care unit who received advance cardiac life support protocol after in hospital cardiac arrest during the period of six months. • Short term survival (Return of spontaneous respiration and circulation) and hospital survival at the time of discharge were measured. • In addition, factors affecting the outcome of CPR age, gender, and duration of CPR, associated arrhythmias, defibrillation and TPM implantation were also taken in account.

  8. RESULTS • Over all 45 out of 126 patients (33%) who received advance cardiopulmonary life support, survived to hospital discharge. • Survival was better in male i.e. 37% versus 26% in female. • young age group showed better survival 40% in age range of 30 to 49 years, 33% in 50 to 69 years and 28% in 70years and older. • Survival rate was 86% when CPR duration was less than 10 minutes, at the 15 minutes 48% and at 20 minutes CPR time, 25% patients survived. Only 13% patients survived at CPR time of 30 minutes.

  9. RESULTS Survival was 42% for patients with VF and 68% in those presenting VT, 61% in fast AF with heamodynamically instability. 29% patients having TPM implantation survived of cardiac arrest. Poor survival in patients of cardiac arrest presenting with new development of LBBB i.e. 18% , best in inferior wall STEMI ( 32%) , intermediate in anterior wall STEMI ( 28%). Total of 30 patients in cardiogenic shock had cardiac arrest and 17% resuscitated successfully

  10. CONCLUSION Survival was highest for patients with primary cardiac arrest, with short CPR duration, young age, male withtachyarrhythmia. Patients who experienced cardiac arrest at cardiac emergency room have better survival. Survival was poor in patients with cardiogenic shocks, CPR duration more than 20 minutes

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