European Journal of Cardiovascular Medicine

Introduction: Cardiopulmonary arrest (CPA) is the cessation of effective ventilation and circulation. It is also known as cardiac arrest or circulatory arrest. In adults, it is most likely to be caused by a primary cardiac event. The most common electrical mechanism which is responsible for 50 to 80% of cardiopulmonary arrest is ventricular fibrillation (VF). While, 20% to 30% which represents the less common causes of dysrhythmias involve Pulseless electrical activity (PEA), and asystole. Pulseless sustained ventricular tachycardia (VT) is a less common mechanism.   Objective:  To study the rate of survival to discharge after in-hospital cardiac arrest and its associated factors in an emergency department of a tertiary care hospital. Materials and Methods: This prospective observational study was conducted in the Department of Cardiology in a Tertiary care Teaching hospital over a period of 6 months among all patients above 18 years old, who suffered witnessed cardiac arrest, after arrival in the emergency department. A semi-structured questionnaire was used to collect data (socio demographic details, chief complaints, comorbidities). Initial documented rhythm, duration of CPR, use of defibrillator, and presumed cause of cardiac arrest and others were collected from the case records. Results: After CPR, 10 (20%) of 50 patients were discharged fully conscious, whereas 40 (80%) patients died; 20 of them died immediately, whereas 20 patients developed hypoxic encephalopathy and died during hospitalization. There was no statistically significant association between age, sex, and associated comorbidities and the outcome of CPR. However, there was a significant inverse relation between the duration of CPR and its outcome. The duration of CPR was significantly lower in survivors (3.80 ±1.90 min) compared with non survivors (11.31 ± 3.41 min) (P<0.001). GCS was significantly higher in survivors group compared with non-survival groups (12.38±0.3 vs 3.68±1.20, P<0.001). Conclusion: These results suggest that out-of-hospital cardiac arrest among children has a very poor prognosis, especially when efforts at resuscitation continue for longer than 20 minutes and require more than two doses of epinephrine.