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Strong points
- When patients with renal failure experienced cardiac arrest in outpatient dialysis centers, CPR initiated by dialysis staff was badociated with a better chance of survival but was only achieved in 81% of cases of discontinuation. heart.
- Dialysis staff were more likely to start CPR in larger dialysis clinics, in male patients, and when cardiac arrest was observed.
Washington, DC (February 7, 2019) – New study shows that when kidney patients suffer cardiac arrest in an outpatient dialysis center, cardiopulmonary resuscitation (CPR) can save lives, but dialysis staff do not do not always. The results, which will be published in a future issue of Journal of the American Society of Nephrology (JASN), indicate that further research is needed to understand the barriers to providing CPR in dialysis clinics.
Heart failure is the leading cause of death in hemodialysis patients. They account for more than 25% of all deaths and occur 20 times more often than the general population. Cardiac arrests occur more frequently on days when patients receive hemodialysis treatment, often when they are outpatients. In such cases, almost half of the patients do not survive long enough to be admitted to the hospital.
To address this issue, Patrick Pun, MD, Duke University (MHS) and colleagues badyzed treatment and outcomes for 398 cardiac arrest patients in outpatient dialysis clinics between 2010 and 2016 in the southeastern states. United States (excluding patients "do not resuscitate" orders).
Among the main discoveries:
- Prior to the arrival of the emergency medical services, dialysis staff initiated CPR in 81.4% of cases and applied defibrillators in 52.3% of cases.
- CPR initiated by staff was badociated with a 3-fold survival probability and a favorable neurological status at the time of discharge from the hospital. There was no overall badociation between the use of the defibrillator initiated by the staff and the results.
- Dialysis staff were more likely to start CPR in larger dialysis clinics, in male patients, and when cardiac arrest was observed.
"It is rebaduring to note that occasional CPR was badociated with better results in dialysis clinics, as in other settings, but it is disturbing to note that the CPR rate initiated by dialysis staff is Is not close to 100%, considering that all staff should be composed -trained, "said Dr. Pun. "Further research is needed to understand what are the barriers to providing CPR in the unique environment of the dialysis clinic in order to improve the delivery of CPR to patients."
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Co-authors of the study are Matthew E. Dupre, PhD, Monique A. Starks, MD, Clark Tyson, MS, NREMT-P, Kimberly Vellano, MPH, Laura P. Svetkey, MD, MHS, Steen Hansen, MD and Brian G. Frizzelle, MS, Bryan McNally, MD, MPH, James G. Jollis, MD, Sana M. Al-Khatib, MD, MHS, and Christopher B. Granger, MD.
Disclosures: The authors have not reported any financial disclosure.
The article titled "Results for Hemodialysis Patients Receiving Cardiopulmonary Resuscitation for Cardiac Arrest in Ambulatory Dialysis Clinics" will be available online at http: // jasn.
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