FACTORS AFFECTING OUTCOME FOLLOWING CARDIOPULMONARY-RESUSCITATION

Many patients who receive cardiopulmonary resuscitation (CPR) for card iac arrest do not survive to leave hospital. Factors associated with a dverse outcomes include unwitnessed cardiac arrest in general wards, p articularly at night, prolonged resuscitation, asystole, associated di sorders (e.g. sepsis, malignancy, renal failure, and left ventricular dysfunction), absent pupillary responses, hypoxaemia, low PetCO2 durin g resuscitation, and severe acid base imbalance. Outside hospitals, ca rdiac arrests result in more favourable outcomes if they occur at work , and bystander CPR and early defibrillation are initiated. On admissi on to ICU likely predictors of death or severe neurological disability include prolonged coma, impaired brainstem reflexes, and persistent c onvulsions. Experience with cerebrospinal fluid enzymes and electrophy siological measurements is limited. Multivariate scoring systems are n ot sufficiently reliable. The importance of hyperglycaemia, the requir ed level of CPR training and the appropriateness of responding to some cases, remain debatable.