Improved Survival After Intraoperative Cardiac Arrest in Noncardiac Surgical Patients

Leonard N. Girardi, MD; Philip S. Barie, MD, FCCM
Arch Surg. 1995;130(1):15-18. doi:10.1001/archsurg.1995.01430010017002.
Text Size: A A A
Published online

Objective:  To test the hypothesis that improvements in intraoperative and perioperative critical care are resulting in an improved outcome after intraoperative cardiac arrest.

Design:  A retrospective consecutive series of patients who experienced an intraoperative cardiac arrest during noncardiothoracic surgical procedures between January 1986 and June 1994.

Setting:  A tertiary care university-based hospital.

Participants:  Twenty-four consecutive patients who experienced an intraoperative arrest among 162 661 noncardiothoracic surgical procedures during the designated period.

Intervention:  Advanced cardiac life support and advanced trauma life support methods were used appropriately. Postarrest pharmacologic and mechanical cardiopulmonary support were used as needed in the setting of a surgical intensive care unit.

Main Outcome Measures:  Survival out of the operating room and survival to discharge.

Results:  Fifteen patients (62%) were resuscitated in the operating room and taken to the surgical intensive care unit or recovery room. Nine patients (38%) survived to discharge from the hospital. Twelve arrests (50%) were primarily cardiac in origin. Predictors of mortality included a need for pressor or inotropic support (P<.001) and duration of the arrest greater than 15 minutes (P<.001).

Conclusion:  Survival from an intraoperative cardiac arrest in a noncardiothoracic surgical patient is much improved over rates in historical controls who experienced in-hospital and out-of-hospital cardiac arrest. Rapid identification and aggressive correction of mechanical and metabolic derangements is warranted.(Arch Surg. 1995;130:15-18)


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.