• L N Girardi and P S Barie.
• Department of Surgery, New York Hospital, Cornell Medical Center, NY.
• Arch Surg Chicago. 1995 Jan 1;130(1):15-8; discussion 19.

ObjectiveTo test the hypothesis that improvements in intraoperative and perioperative critical care are resulting in an improved outcome after intraoperative cardiac arrest.DesignA retrospective consecutive series of patients who experienced an intraoperative cardiac arrest during noncardiothoracic surgical procedures between January 1986 and June 1994.SettingA tertiary care university-based hospital.ParticipantsTwenty-four consecutive patients who experienced an intraoperative arrest among 162,661 noncardiothoracic surgical procedures during the designated period.InterventionAdvanced 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 MeasuresSurvival out of the operating room and survival to discharge.ResultsFifteen 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).ConclusionSurvival 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.

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