Article Data

  • Views 1581
  • Dowloads 119

Original Research

Open Access

Assessing outcome of out-of-hospital cardiac arrest due to subarachnoid hemorrhage using brain CT during or immediately after resuscitation

  • NORIYUKI SUZUKI1
  • YOSHIHIRO MORIWAKI1
  • HIROSHI MANAKA1
  • KOICHI HAMADA1

1Yokohama City Univ, Crit Care & Emergency Ctr, Med Ctr

DOI: 10.22514/SV52.112010.3 Vol.5,Issue 2,November 2010 pp.21-24

Published: 01 November 2010

*Corresponding Author(s): YOSHIHIRO MORIWAKI E-mail: qqc3@yokohama-cu.ac.jp

Abstract

Objectives. The clinical course and outcome of out-of-hospital cardiopulmonary arrest (OHCPA) due to subarachnoid hemorrhage (SAH) is unclear. The objective of this study is to clarify them. 

Study design. Single- center, observational study. 

Setting. We usually perform a brain computed tomography (CT) in OHCPA patients who present without a clear etiology (42% of all OHCPA), such as trauma, to determine the cause of OHCPA and to guide treatment. 

Patients. The study included OHCPA patients without a clear etiology, who were transferred to our center and who underwent a brain CT during resuscitation. 

Methods of measurement. Patients’ records were reviewed; initial cardiac rhythm, existence of a witness and bystander cardiopulmonary resuscitation efforts (CPR) were compared with patients’ outcomes. 

Results. Sixty-six patients were enrolled. 72.7% achieved return of spontaneous circulation (ROSC), 71.2% were admitted, 30.3% survived more than 7 days, and 9.1. survived-to-discharge. In 41 witnessed OHCPA, 87.8% obtained ROSC, 85.4% were admitted, and 14.6% survived-to-discharge. All survivors were witnessed. In 25 non-witnessed OHCPA, 48% obtained ROSC and were admitted, and no patients were discharged. Initial cardiac rhythm was ventricular fibrillation (VF), pulseless electrical activity (PEA) and asystole in 3.0%, 39.4%, and 47.0%. In 2 VF patients 50.0% survived-to- discharge, and there was no survivor with PEA or asystole.

Conclusion. This study shows a high rate of ROSC and admission in OHCPA patients with a SAH, and also reveals their very poor neurological outcome. We conclude that the detection of a SAH in OHCPA patients is important to determine the accurate frequency of SAH in this patient group and to guide appropriate treatment of all OHCPA patients.

Keywords

out-of-hospital cardiac arrest, brain CT, outcome, autopsy imaging, postmortem imaging

Cite and Share

NORIYUKI SUZUKI,YOSHIHIRO MORIWAKI,HIROSHI MANAKA,KOICHI HAMADA. Assessing outcome of out-of-hospital cardiac arrest due to subarachnoid hemorrhage using brain CT during or immediately after resuscitation. Signa Vitae. 2010. 5(2);21-24.

References

1. Moriwaki Y, Tahara Y, Arata S, Toyoda H, Iwashita M, Kosuge T, et al. Etiology of out-of-hospital cardiac arrest due to non-cardiac origin in Japan. Intensive Care Med 2009;35:S144.

2. Moriwaki Y, Sugiyama M, Hayashi H, Mosiello G, Cremonese F, Altomani V, et al. Emergency medical service system in Yokohama, Japan. Annali Degli Ospedali San Camillo e Forlanini 3 2001;344 56.

3. Moriwaki Y, Sugiyama M, Toyoda H, Kosuge T, Takahashi K, Iwashita M, et al. Monitoring and evaluation of intraperitoneal bleeding (IPB) by small portable ultrasonography during transcatheter arterial embolization (TAE) in abdominal-pelvic trauma patients with shock: as a monitor for early detection of increase of IPB. Hepatogastroenterol 2006;53:175-8.

4. Moriwaki Y, Sugiyama M, Toyoda H, Kosuge T, Iwashita M, Ishikawa J, et al. Bystander CPR for out-of-hospital cardiac arrest in Japan. Crit Care 2007;11:S130-1.

5. Moriwaki Y, Sugiyama M, Suzuki N. Outcome of blunt traumatic cardiopulmonary arrest. Intensive Care Med 2007;33:S269.

6. Kurkciyan I, Meron G, Sterz F, Domanovits H, Tobler K, Laggner AN, et al. Spontaneous subarachnoid hemorrhage as a cause of out-of-hospital cardiac arrest. Resuscitation 2001;51:27-32.

7. Schievink WI, Wijdicks EF, Parisi JE, Piepgras DG, Whisnant JP. Sudden death from aneurismal subarachnoid hemorrhage. Neurology 1995;45:871-4.

8. Inamasu J, Miyatake S, Tomioka H, Suzuki M, Nakatsukasa M, Maeda N, et al. Subarachnoid hemorrhage as a cause of out-of-hospital cardiac arrest: a prospective computed tomography study. Resuscitation 2009;80:977-80.

9. Shapiro S. Management of subarachnoid hemorrhage patients who presented with respiratory arrest resuscitated with bystander CPR. Stroke 1996;27:1780-2.

10. Macrea LM, Tramer MR, Walder B. Spontaneous subarachnoid hemorrhage and serious cardiopulmonary dysfunction? A systematic review. Resuscitation 2005;65:139-48.

11. Tabbaa MA, Ramirez-Lassepas M, Snyder BD. Aneurismal subarachnoid hemorrhage presenting as cardiorespiratory arrest. Arch Intern Med 1987;147:1661-2.

12. Noritomi DT, de Cleva R, Beer I, Dalbem AG, Liborio AB, Frota NA, et al. Doctor’s awareness of spontaneous subarachnoid hemorrhage as a cause of cardiopulmonary arrest. Resuscitation 2006;71:123-4.

13. Inamasu J, Saito R, Nakamura Y, Ichikizaki K, Suga S, Kawase T, et al. Survival of a subarachnoid hemorrhage patient who presented with prehospital cardiopulmonary arrest: case report and review of the literature. Resuscitation. 2001;51:207-11.

14. Hess EP, Boie ET, White RD. Survival of a neurologically intact patient with subarachnoid hemorrhage and cardiopulmonary arrest. Mayo Clin Proc. 2005;80:1073-6.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top