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- Title
Changes in cardiac arrest profiles after the implementation of a Rapid Response Team.
- Authors
Verçoza Viana, Marina; Silva Leite Nunes, Diego; Teixeira, Cassiano; Rios Vieira, Silvia Regina; Torres, Grazziela; Salles Brauner, Janete; Müller, Helena; Dutra Butelli, Thais Crivellaro; Boniatti, Marcio Manozzo
- Abstract
Objective: To evaluate changes in the characteristics of in-hospital cardiac arrest after the implementation of a Rapid Response Team. Methods: This was a prospective observational study of in-hospital cardiac arrest that occurred from January 2013 to December 2017. The exclusion criterion was in-hospital cardiac arrest in the intensive care unit, emergency room or operating room. The Rapid Response Team was implemented in July 2014 in the study hospital. Patients were classified into two groups: a Pre- Rapid Response Team (in-hospital cardiac arrest before Rapid Response Team implementation) and a Post-Rapid Response Team (inhospital cardiac arrest after Rapid Response Team implementation). Patients were followed until hospital discharge or death. Results: We had a total of 308 cardiac arrests (64.6 ± 15.2 years, 60.3% men, 13.9% with initial shockable rhythm). There was a decrease from 4.2 to 2.5 in-hospital cardiac arrest/1000 admissions after implementation of the Rapid Response Team, and we had approximately 124 calls/1000 admissions. Pre-Rapid Response Team cardiac arrest was associated with more hypoxia (29.4 versus 14.3%; p = 0.006) and an altered respiratory rate (14.7 versus 4.2%; p = 0.004) compared with post- Rapid Response Team cardiac arrest. Cardiac arrest due to hypoxia was more common before Rapid Response Team implementation (61.2 versus 38.1%, p < 0.001). In multivariate analysis, return of spontaneous circulation was associated with shockable rhythm (OR 2.97; IC95% 1.04 - 8.43) and witnessed cardiac arrest (OR 2.52; IC95% 1.39 - 4.59) but not with Rapid Response Team implementation (OR 1.40; IC95% 0.70 - 2.81) or premonitory signs (OR 0.71; IC95% 0.39 - 1.28). In multivariate analysis, in-hospital mortality was associated with non-shockable rhythm (OR 5.34; IC95% 2.28 - 12.53) and age (OR 1.03; IC95% 1.01 - 1.05) but not with Rapid Response Team implementation (OR 0.89; IC95% 0.40 - 2.02). Conclusion: Even though Rapid Response Team implementation is associated with a reduction in inhospital cardiac arrest, it was not associated with the mortality of in-hospital cardiac arrest victims. A significant decrease in cardiac arrests due to respiratory causes was noted after Rapid Response Team implementation.
- Subjects
CARDIAC arrest; INTENSIVE care units; HYPOXEMIA; RAPID response teams
- Publication
Revista Brasileira de Terapia Intensiva, 2021, Vol 33, Issue 1, p96
- ISSN
0103-507X
- Publication type
Article
- DOI
10.5935/0103-507X.20210010