Vol. 43 | No. 2 | July-December 2015 Back

Open Access

The Filipino Cardiopulmonary Resuscitation Outcomes Study (Filipino CPR 2015) Among Adult Cardiac Arrest Patients in Tertiary Hospitals in the Philippines: A Prospective Study

Jerelyn Adviento, Orlando Bugarin, Ma. Kristine Joy S. Calvario, Alex Junia, Francis  Lavapie, Maria Luz Joanna Soria, Regidor Encabo, Vinhcent Sandoval, Rochelle Cruz, Alvin Dela Cruz, Ivan Valdez, Kathleen Cala, Arnee Anico-Tondo, Banisadar Mukaram,  Cecile Jaca, Aileen Lomarda Catapang, Neil Salces, Ciara Lesaca, Gina Ogaco, Nina Noreen Diansuy, Joseph Marc Seguban, Marylis E. Javier, Nelson Acorda, Sharon  Dispo, Lotlot Awil, Albert Hans Bautista, Ma. Magdalena Avelino, Jeannica Kriselle Lerios,  Nestor Lino Bagsit, Don Robespierre Reyes, Franco Onswald C. Rubrica, Walid A. Amil,  Abdeltazer Mohammad
Dec 2015 DOI 10.69944/pjc.1632410c33

Abstract

Cardiopulmonary resuscitation (CPR) saves lives, but proper techniques must be taught and practiced. Outcomes have to be assessed to improve patient survival. 

Methods: This is an observational, analytical, prospective study of CPR in adult cardiac arrest cases from selected tertiary hospitals in the Philippines. It describes the characteristics and clinical factors associated with CPR survival in the Philippines based on the American Heart Association 2010 guidelines. Validated Philippine Heart Association hospital cardiac arrest collection forms were used to gather data on the demographics, pre-arrest and CPR/code characteristics of the cases. The investigators analyzed survival outcomes from first arrest to initial return of spontaneous circulation (ROSC) to hospital discharge. Epi Info 6 and STATA 11 statistical software were used for descriptive and inferential statistics, while the chi-square test was used for the association of variables (significant P-value set at <0.05). Stratified analysis and logistic regression analysis were done for confounders. Odds ratios (OR), 95% CI, and p-values were reported. 

Results: Out of 156 patients, 101 (65%) survived up to ROSC and hospital discharge. The investigators found significant differences in patient survival under the following factors: CPR medications (OR=16.729; 95% CI 1.979, 141.375; P=0.0097); and post-arrest therapeutic hypothermia (OR=8.745; CI 1.826, 41.882; P=0.0067). There were some decision errors on the use of defibrillation for shockable rhythms (26%) and non-shockable rhythms (14.5%). Eighteen rhythms were not properly identified. 

Conclusion: Decreased interval time from arrest to intubation and from arrest to call for code, CPR medications, and post-arrest therapeutic hypothermia were the most significant contributors to CPR survival in this study. Future training should address the errors in cardiac rhythm interpretation and defibrillator use. 

Keywords: CPR, ROSC, defibrillation, hypothermia, survival

 

References
  1. Dumot JA, Burval DJ, Sprung J, Waters JH, Mraovic B, Karafa MT, Mascha EJ, Bourke DL. Outcome of adult cardiopulmonary resuscitations at a tertiary referral center including results of limited resuscitations. Arch Intern Med. 2001 Jul 23;161(14):1751-8. 
  2. Hazinski MF, Field JM. 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science. Circulation. 2010;122(Suppl):S639-946. 
  3. Peters R, Boyde M. Improving survival after in-hospital cardiac arrest: the Australian experience. Am J Crit Care. 2007 May 1;16(3):240-7. 
  4. Potenza B, Nolan J. Mechanisms and epidemiology of trauma. In: Wilson WC, Grande CM, Hoyt DB, eds. Trauma: Resuscitation, Perioperative Management, and Critical Care. CRC Press, 2007:25- 42. 
  5. Safar P, Elam J, eds. Advances in Cardiopulmonary Resuscitation. New York: Springer-Verlag, 1977:63. 
  6. American Heart Association. 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S315-589.
  7. Philippine Health Research Ethics Board. National ethical guidelines for health research. 2011. 
  8. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013 Nov 27;310(20):2191. 
  9. Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L, Cassan P, Coovadia A, D’Este K, Finn J, Halperin H. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa). Circulation. 2004 Nov;110(21):3385-97. 
  10. World Health Organization [Internet]. Philippines. Available from: www.who.int/countries/phl/en/ Accessed on: 30 July 2016.
License

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.