Resuscitation
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Previous reports from general hospitals and cancer centers have identified the presence of malignancy as a poor prognostic indicator for successful cardiopulmonary resuscitation (CPR) for an in-hospital cardiac arrest. The purpose of this study was to evaluate the initial success of CPR as determined by return of spontaneous circulation (ROSC), patient survival to hospital discharge, and 1-year survival of this group as compared to previous studies in non-oncological centers. In addition, the charges incurred in caring for these patients were analyzed. ⋯ Although ROSC after cardiac arrest in our patients was better than that reported for most series in general hospitals, their ultimate survival and hospital discharge was extremely poor.
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To develop and validate a logistic regression model to identify predictors of death before hospital discharge after in-hospital cardiac arrest. ⋯ Performance of this logistic regression model depends on the cut-off probability chosen to discriminate between predicted survival and predicted death and on whether the estimated probability or the lower 95% C.L. of the estimated probability is used. This model may inform the development of clinical practice guidelines for patients who are at risk of or who experience in-hospital cardiac arrest.
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To assess the hemodynamic response to repeated doses of epinephrine (EPI) in an animal model of prolonged cardiac arrest and CPR. ⋯ The hemodynamic response to the first dose of EPI determines if the critical CPP needed for ROSC and survival will occur. Repeat doses of EPI do not appear to improve CPP to a degree to affect clinically meaningful measures of outcome, i.e., successful countershock and survival.