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Largest study of in-hospital cardiac arrest suggests how to improve outcomes for children and adults

Children survive in-hospital cardiac arrests more frequently than adults, cardiopulmonary resuscitation (CPR) may improve outcomes for both groups, and better knowledge of the underlying cause of a cardiac arrest may increase the chances of helping a patient survive it. These are some of the findings of the largest-ever study of cardiac arrests occurring in hospitals.

Researchers from the National Registry of CPR have released a study that challenges conventional medical wisdom about the patterns and causes of these life-threatening events. "Not all cardiac arrests are the same," said study leader Vinay Nadkarni, M.D., a specialist in Critical Care Medicine at The Children's Hospital of Philadelphia. "Our results suggest that hospital caregivers need to carefully tailor their resuscitations to a patient's situation, and not follow a blanket protocol based only on the patient's age."

The research appears in the January 4 issue of the Journal of the American Medical Association. The American Heart Association's National Registry of Cardiopulmonary Resuscitation (NRCPR) collected data from 253 hospitals in the United States and Canada between 2000 and 2004. The NRCPR investigators analyzed details of nearly 37,000 adults and 880 children who had pulseless cardiac arrests in the hospital. Their work provides a broad descriptive picture of how cardiac arrests occur and are treated.

The researchers found that cardiac arrests within a hospital are quite different from those occurring outside the hospital. "For both children and adults, most in-hospital cardiac arrests are caused by progressive respiratory failure and shock, not by a sudden arrhythmia," said Dr. Nadkarni. "Many adult physicians assume that the vast majority of adult cardiac arrests in hospitals are from sudden arrhythmias, and life-support protocols reflect this assumption. Our findings show that respiratory failure is more common than arrhythmia in adults, and in such cases emergenc
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Contact: John Ascenzi
Ascenzi@email.chop.edu
267-426-6055
Children's Hospital of Philadelphia
3-Jan-2006


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