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• W4313235971 abstract "Introduction: Survivorship from traumatic cardiac arrest (TCA) is uncommon. Controversy remains regarding candidacy for resuscitation and how it proceeds. Recent literature suggests initial resuscitation efforts focused on treating rapidly reversible causes of TCA (airway, pneumothorax, hemorrhagic shock) rather than ATLS + CPR are an equal or better use of both time and resources. Methods: Retrospective review of patients presenting in TCA to a Level I trauma center from 2016-2021 was conducted. Primary outcome was ROSC with >24-hour survival (24hrSURV). Secondary outcomes included age, overall survival, return of spontaneous circulation (ROSC), and total asystolic time (AT). Results: 238 of 285 of patients presenting in TCA had complete data for analysis. 137 (57.5%) were DOA. Resuscitation was attempted in 101 patients. Continued, delayed, or no CPR was at attending discretion. Median age was 40 (range:1wk-90yrs). 68 patients underwent continued CPR upon arrival. 33 received delayed (N=8) or no CPR (N=25). Of those undergoing continued CPR, 29% achieved ROSC compared to 33% in the delayed or no CPR cohort. Median age for those who achieved ROSC was 46 years vs. 40 years for those without ROSC. Median AT for patients achieving ROSC was 13 minutes vs. 19 minutes in those without ROSC. 7 patients reached 24hrSURV, of which median age was 48.1 +/- 17.2 (range:19-69yrs) and AT to ROSC was 17.8 +/-10.3 minutes (range:6 to 47min). Mechanisms included 2 penetrating, 4 blunt and 1 mixed. Two patients survived and discharged to home: one blunt and one penetrating, both of whom received continued CPR and had ROSC at 13 minutes AT. Three patients succumbed to anoxic brain injury, one of whom underwent non-CPR resuscitation. The remaining deaths in the 24hrSURV group were from MSOF in a mixed mechanism non-CPR patient and ARDS in a blunt +CPR patient. Conclusions: Traumatic arrest rarely results in survival. Efforts focused on rapidly reversible causes rather than CPR can result in successful ROSC. ROSC may be achieved in trauma arrest beyond 20 minutes of resuscitation. 24-hr survivorship beyond age 69 and survival to discharge beyond age 60 was not observed, suggesting resuscitation from TCA in ages > 60 is futile. Both patients who survived to discharge home neurologically intact received CPR." @default.
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• W4313235971 date "2022-12-15" @default.
• W4313235971 modified "2023-09-26" @default.
• W4313235971 title "1311: TRAUMATIC ARREST: THE UNRESOLVED ROLE OF CPR" @default.
• W4313235971 doi "https://doi.org/10.1097/01.ccm.0000910980.87731.31" @default.
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