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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Right ventricular dysfunction after resuscitation predicts poor outcomes in cardiac arrest patients independent of left ventricular function
Resuscitation, v 96
Nov 2015
PMID: 26318576
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Determination of clinical outcomes following resuscitation from cardiac arrest remains elusive in the immediate post-arrest period. Echocardiographic assessment shortly after resuscitation has largely focused on left ventricular (LV) function. We aimed to determine whether post-arrest right ventricular (RV) dysfunction predicts worse survival and poor neurologic outcome in cardiac arrest patients, independent of LV dysfunction.
A single-center, retrospective cohort study at a tertiary care university hospital participating in the Penn Alliance for Therapeutic Hypothermia (PATH) Registry between 2000 and 2012.
291 in- and out-of-hospital adult cardiac arrest patients at the University of Pennsylvania who had return of spontaneous circulation (ROSC) and post-arrest echocardiograms.
Of the 291 patients, 57% were male, with a mean age of 59±16 years. 179 (63%) patients had LV dysfunction, 173 (59%) had RV dysfunction, and 124 (44%) had biventricular dysfunction on the initial post-arrest echocardiogram. Independent of LV function, RV dysfunction was predictive of worse survival (mild or moderate: OR 0.51, CI 0.26–0.99, p<0.05; severe: OR 0.19, CI 0.06–0.65, p=0.008) and neurologic outcome (mild or moderate: OR 0.33, CI 0.17–0.65, p=0.001; severe: OR 0.11, CI 0.02–0.50, p=0.005) compared to patients with normal RV function after cardiac arrest.
Echocardiographic findings of post-arrest RV dysfunction were equally prevalent as LV dysfunction. RV dysfunction was significantly predictive of worse outcomes in post-arrest patients after accounting for LV dysfunction. Post-arrest RV dysfunction may be useful for risk stratification and management in this high-mortality population.
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Details
- Title
- Right ventricular dysfunction after resuscitation predicts poor outcomes in cardiac arrest patients independent of left ventricular function
- Creators
- Vimal Ramjee - University of PennsylvaniaAnne V. Grossestreuer - Center for Resuscitation Science, University of Pennsylvania, United StatesYuan Yao - Drexel UniversitySarah M. Perman - University of Colorado DenverMarion Leary - Center for Resuscitation Science, University of Pennsylvania, United StatesJames N. Kirkpatrick - University of PennsylvaniaPaul R. Forfia - Temple UniversityDaniel M. Kolansky - University of PennsylvaniaBenjamin S. Abella - Center for Resuscitation Science, University of Pennsylvania, United StatesDavid F. Gaieski - Thomas Jefferson University
- Publication Details
- Resuscitation, v 96
- Publisher
- Elsevier Ireland Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Microbiology and Immunology
- Web of Science ID
- WOS:000366584500038
- Scopus ID
- 2-s2.0-84944886346
- Other Identifier
- 991019167692104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Emergency Medicine