Systemic Complications of Comatose Survivors Following Cardiopulmonary Resuscitation

ABSTRACT

PURPOSE: To describe systemic complications of unconscious patients' survival six hours following cardiopulmonary resuscitation (CPR), and to evaluate the relationship between several variables and death. METHODS: We conducted a retrospective analysis of 153 cases of non-traumatic cardiac arrest that received CPR in a tertiary emergency department from April 1997 to June 2007. We carried out analyses on survival cases, and studied general characteristics and systemic complications to ascertain relationships between the survival and death groups. RESULTS: Sixty of 153 patients initially survived, but the survival rate quickly decreased to 30.1% within the first three days and then decreased slowly thereafter. In the 153 patients, hyperamylasemia occurred in 101 patients (66.0%), acute liver injury in 75(49.0%), sepsis in 67(43.8%), seizure and refractory shock in 66(43.1%), pneumonia in 65(42.5%), acute renal failure (ARF) in 64(41.8%), acute respiratory distress syndrome (ARDS) in 30(19.6%), and disseminated intravascular coagulation (DIC) in 26(17.0%). Of nine types of complications encountered, the incidences of hyperamylasemia, ARDS, ARF, refractory shock and DIC were significantly higher in patients who died than in those who survived (73.1% vs 55.0%, 28.0% vs 6.7%, 54.8% vs 21.7%, 66.7% vs 6.7%, and 23.7% vs 6.7%, respectively). CONCLUSION: Systemic complications occurred with high frequency in comatose survivors after cardiopulmonary resuscitation. Hyperamylasemia, ARDS, ARF, refractory shock and DIC were significantly associated with death.