In-hospital Cardiopulmonary Resuscitation during Asystole: Results
Table 2 presents survival statistics for patients grouped according to whether or not the patient received norepinephrine and lidocaine drips, and/or a pacemaker. One patient was excluded from this analysis due to incomplete data. Patients who received norepinephrine and/or lidocaine drip, but not a pacemaker were significantly more likely to survive than were those who received a pacemaker without having received norepinephrine and/or lidocaine drip (57.1 percent vs 3.3 percent; p<.001). One way analysis of variance and post-hoc comparisons (Scheffe method) revealed that among patients who had not received norepinephrine or lidocaine drip, the duration of resuscitation efforts was significantly shorter than among those who received norepinephrine and/or lidocaine (M ± SE; 21.8 ± 1.8 minutes vs 39.9 ±5.9; p<.001). Differences across groups on age, as well as the remaining categorical variables, were nonsignificant.
Figure 1 presents data concerning the difference in 24-h and discharge survival rates between those patients who did and did not receive both epinephrine and atropine, with and without subsequent administration of norepinephrine and lidocaine drips. For this analysis, three patients had incomplete data and were therefore excluded. Among those who received norepinephrine and lidocaine drips in addition to the AHA-recommended epinephrine and atropine (N = 12), 58.3 percent survived 24 h while only 12.3 percent of those who received epinephrine and atropine but not norepinephrine and lidocaine (N = 73) survived (p<.001). The overall statistical difference in 24-h survival between those patients who received the AHA-rec-ommended procedures (N = 85, 18.8 percent survived) and those who did not (N = 35, 34.3 percent survived) was not significant (p = .07). cheap-asthma-inhalers.com
It should be pointed out that only two (14.2 percent) of the 14 patients who received norepinephrine and lidocaine had not first received epinephrine and atropine. Of these, one survived and one died. Epinephrine and atropine were not administered in 33 cases. In 11 of the cases (33.3 percent), the patient was resuscitated after use of more conservative measures. In the remaining 22 cases, the decision was made by the responding code team that such efforts were unwarranted.
Table 2—Status 24 h after Initiation of CPR by Treatment Combinations
|Treatment Combinations||Total,N(%)||Alive,N(%)||Died, N (%)|
|Norepinephrine||? Lidocaine||( Pacer|
|No||No||No||40 (33.3)||8 (20.0)||32 (80.0)|
|No||No||Yes||31 (25.8)||1 (3.2)||30 (96.8)|
|Yes||No||No||13 (10.8)||5 (38.5)||8 (61.5)|
|Yes||No||Yes||15 (12.5)||4 (26.7)||11 (73.3)|
|No||Yes||No||3 (2.5)||2 (66.7)||1 (33.3)|
|No||Yes||Yes||4 (3.3)||0 (0.0)||4 (100)|
|Yes||Yes||No||6 (5.0)||5 (83.3)||1 (16.7)|
|Yes||Yes||Yes||8 (6.7)||3 (37.5)||5 (62.5)|
Figure 1. Survival statistics for patients who received epinephrine and atropine and/or norepinephrine and lidocaine.