Clinical findings and outcomes of intra-hemodialysis cardiopulmonary resuscitation
Journal
American Journal of Nephrology
Journal Volume
19
Journal Issue
4
Pages
468-473
Date Issued
1999
Author(s)
Abstract
Renal failure with severe uremia is still an important cause of mortality, despite effective renal replacement therapy. Cardiopulmonary arrest (CPA) is the most severe complication during hemodialysis (HD). To acquire more information about cardiopulmonary resuscitation (CPR) during HD, we retrospectively enrolled 24 patients (11 males and 13 females) who had CPR during HD in a medical center during a 3-year period. Their mean age was 66.8 ± 16.8 years. The CPR rate of the patients from our outpatient department (0.02%) was significantly lower than that from general wards (0.11%), the intensive care unit (ICU, 0.16%), or the emergency room (ER, 0.38%). Eighteen patients (75%) were initially resuscitated successfully. Only 11 patients (45.8%) survived more than 24 h after CPR, and 2 patients (8.3%) survived more than 1 month, but none survived until discharge. The rates of surviving 24 h and surviving to discharge during HD were lower than those in the general wards, the ICU or the ER. Sepsis (33.3%) and cardiogenic shock (25%) were the two leading causes of death. For analyzing factors affecting the outcome of CPR, we divided the patients into 2 groups by survival time (? 24 vs, > 24 h). Patients with heart disease or with prolonged CPR durations (> 30 min) had shorter survival. No significant survival difference between the 2 groups was found due to factors of age, sex, diabetic nephropathy, pre-arrest morbidity scores, pre-arrest laboratory data, renal failure pattern, HD duration, the preceding HD time and ultrafiltrated volume.
SDGs
Other Subjects
adult; aged; article; cardiogenic shock; cardiopulmonary arrest; cause of death; clinical article; emergency ward; female; heart disease; hemodialysis; human; intensive care; kidney failure; male; mortality; outpatient department; priority journal; resuscitation; retrospective study; sepsis; survival; survival time; treatment outcome; ward; Aged; Cardiopulmonary Resuscitation; Case-Control Studies; Female; Heart Arrest; Humans; Incidence; Kidney Failure; Male; Renal Dialysis; Retrospective Studies; Time Factors
Type
journal article