Introduction
Materials and methods
Review questions
-
Among adults who are admitted to hospital after successful resuscitation from cardiac arrest (P), what is the prevalence of brain death at hospital discharge (O)?
-
Among adults who develop brain death after successful resuscitation from cardiac arrest (P), what is the rate of organ donation (O)?
Inclusion and exclusion criteria
Search strategy and study selection
Data extraction and analysis
Grading
Results
Study selection
Patient characteristics
Author, year [reference] | IHCA or OHCA | No. of patients | Males, n (%) | Age, yeara
| VF/pVT, n (%) | Witnessed, n (%) | TTM, n (%) |
---|---|---|---|---|---|---|---|
c-CPR
| |||||||
Adrie, 2008 [8] | OHCA | 246 | 174 (70.7) | 55.2 ± 17.6 | 62 (25.2) | 198 (80.5) | 71 (28.9) |
Bernard, 2002 [14] | OHCA | 77 | 52 (67.5) | 66.5 ± 9.7 | 77 (100) | 73 (94.8) | 48 (55.8) |
Calderon, 2014 [26] | Mixed | 72 | 42 (58.3) | 59.0 ± 16 | 31 (43.1) | N/A | 72 (100) |
Dragancea, 2013 [6] | Mixed | 159 | 109 (68.6) | 67 ± 13.7 | 97 (60.5) | N/A | 159 (100) |
Elmer, 2016 [27] | OHCA | 4265 | 2740 (64.2) | 65 (53–77) | 1835 (43) | 2809 (65.9) | 1858 (43.8) |
Geocadin, 2006 [5] | Mixed | 58 | 41 (70.7) | 57.2 ± 15 | N/A | N/A | N/A |
Greer, 2013 [28] | Mixed | 200 | 124 (62) | 59.9 ± 16.5 | 68 (34) | N/A | 39 (19.5) |
Grossestreuer, 2013 [29] | OHCA | 194 | 114 (58.8) | 57.0 ± 16 | 76 (40) | N/A | 194 (100) |
Lemiale, 2013 [4] | OHCA | 1152 | 842 (73.1) | 58.4 ± 15.4 | 654 (56.8) | 1054 (87.7) | 764 (66.3) |
Mentzelopoulos, 2013 [30] | IHCA | 268 | 183 (68.3) | 63 ± 18.2 | 45 (16.8) | 247 (92.2) | 68 (25.4) |
Mulder, 2014 [31] | OHCA | 154 | 104 (67.5) | 59.0 ± 16 | 83 (53.9) | 154 (100) | 154 (100) |
Nielsen, 2013 [32] | OHCA | 939 | 761 (81) | 64 ± 12.6 | 752 (80.1) | 839 (89.4) | 939 (100) |
Peberdy, 2003 [33] | IHCA | 14,720 | 8390 (57) | 67.0 ± 15 | 3680 (25) | 12,659 (86) | N/A |
Rundgren, 2010 [34] | Mixed | 95 | 68 (71.6) | 65 (50–74) | 57 (60) | N/A | 95 (100) |
Sivaraju, 2015 [35] | N/A | 100 | 59 (59) | 62.3 ± 16.2 | 33 (33) | N/A | 100 (100) |
Stammet, 2009 [36] | Mixed | 45 | 30 (66.7) | 56 ± 17 | 22 (48.9) | N/A | 45 (100) |
Total c-CPR
|
22,744
|
13,833 (60.8)
|
60.9 ± 0.86
b
|
7572 (33.3)
|
18,033 (82.6)
|
4601 (57.8)
| |
e-CPR
| |||||||
Avalli, 2012 [37] | Mixed | 42 | 33 (78.6) | 64.8 ± 11.7 | 28 (66.7) | 42 (100) | 42 (100) |
Fagnoul, 2013 [38] | Mixed | 24 | 14 (58.3) | 48 (38–55) | 10 (41.7) | 22 (91.7) | 17 (70.8) |
Lamhaut, 2013 [39] | OHCA | 7 | 6 (85.7) | 42 ± 16 | 5 (71.4) | 7 (100) | 7 (100) |
Le Guen, 2011 [40] | OHCA | 51 | 46 (90.2) | 42 ± 15 | 32 (62.7) | 51 (100) | 51 (100) |
Massetti, 2005 [41] | Mixed | 40 | 23 (57.5) | 42 ± 15 | N/A | N/A | N/A |
Megarbane, 2007 [42] | Mixed | 17 | 5 (29.4) | 47 (27–57) | 0 | 17 (100) | 17 (100) |
Megarbane, 2011 [43] | Mixed | 66 | 51 (77.3) | 46 (39–55) | 30 (45.5) | 66 (100) | 66 (100) |
Pozzi, 2016 [44] | OHCA | 68 | 50 (73.5) | 43.7 ± 11.4 | 32 (47.1) | 68 (100) | 68 (100) |
Rousse, 2015 [45] | OHCA | 32 | 23 (71.9) | 43.2 ± 14.3 | 19 (59.4) | 32 (100) | 32 (100) |
Thiagarajan, 2009 [46] | N/A | 297 | 195 (65.7) | 52 (35–64) | N/A | N/A | N/A |
Total e-CPR
|
644
|
466 (72.4)
|
47.6 ± 1.44
b
* |
156 (50.8)*
|
305 (99.3)*
|
300 (97.7)*
| |
Overall
|
23,388
|
14,299 (61.1)
|
57.5 ± 0.74
b
|
7728 (33)
|
18,338 (82.9)
|
4901 (59.2)
|
Author, year [reference] | Duration of cardiac arrest, mina
|
---|---|
Adrie, 2008 [8] | 32.0 ± 6.6 |
Bernard, 2002 [14] | 25.7 ± 8.1 |
Dragancea, 2013 [6] | 20 ± 26.4 |
Elmer, 2016 [27] | 23.3 ± 0.15 |
Lemiale, 2013 [4] | 24.1 ± 0.6 |
Mentzelopoulos, 2013 [30] | 16.1 ± 8.0 |
Mulder, 2014 [31] | 23 ± 1.4 |
Nielsen, 2013 [32] | 27.4 ± 8.0 |
Rundgren, 2010 [34] | 21.3 ± 1.2 |
Sivaraju, 2015 [35] | 14.7 ± 8.1 |
Stammet, 2009 [36] | 25 [3–90] |
c-CPR
|
24.0 ± 1.7
|
Avalli, 2012 [37] | 69.1 ± 3.9 |
Fagnoul, 2013 [38] | 57.7 ± 0.8 |
Lamhaut, 2013 [39] | 79.0 ± 5.7 |
Massetti, 2005 [41] | 105.0 ± 7.0 |
Megarbane, 2007 [42] | 129.7 ± 11.7 |
Megarbane, 2011 [43] | 151.7 ± 5.6 |
Pozzi, 2016 [44] | 85.4 ± 2.6 |
Rousse, 2015 [45] | 115.5 ± 3.5 |
e-CPR
|
94.7 ± 2.9*
|
Overall
|
42.4 ± 1.5
|
Outcomes
Author, year [reference] | Days after arresta
|
---|---|
Adrie, 2008 [8] | 2.5 (2.0–4.2) |
Avalli, 2012 [37] | 3 (3–4) |
Bernard, 2002 [14] | 3 [2–4] |
Calderon, 2014 [26] | 3.8 ± 1.7 |
Dragancea, 2013 [6] | 5.0 ± 1.3 |
Fagnoul, 2013 [38] | 0.1 [0.1–2] |
Lemiale, 2013 [4] | 5 [3–6] |
Nielsen, 2013 [32] | 3.1 ± 1.2 |
Pozzi, 2016 [44] | 1.3 ± 2.1 |
Rundgren, 2010 [34] | 5.3 ± 1.5 |
Stammet, 2009 [36] | 2 (1–3) |
Overall (mean ± SE)
|
3.2 ± 0.4
|
Author, year [reference] | No. of patients | Mortality, n (%) | Brain death rate | Organ donation rate | ||||
---|---|---|---|---|---|---|---|---|
n
| % Of total patients | % Of deaths |
n
| % Of brain deaths | % Of deaths | |||
c-CPR
| ||||||||
Adrie, 2008 [8] | 246 | 210 (85) | 40 | 16.3 | 19.0 | 19 | 47.5 | 9.1 |
Bernard, 2002 [14] | 77 | 45 (58) | 2 | 2.6 | 4.4 | |||
Calderon, 2014 [26] | 72 | 46 (64) | 8 | 11.1 | 17.4 | |||
Dragancea, 2013 [6] | 159 | 84 (53) | 4 | 2.5 | 4.8 | 4 | 100 | 4.8 |
Elmer, 2016 [27] | 4265 | 2775 (65) | 305 | 7.2 | 11.0 | |||
Geocadin, 2006 [5] | 58 | 48 (83) | 1 | 1.7 | 2.1 | |||
Greer, 2013 [28] | 200 | 180 (90) | 20 | 10.0 | 11.1 | |||
Grossestreuer, 2013 [29] | 194 | 109 (56) | 4 | 2.1 | 3.7 | |||
Lemiale, 2013 [4] | 1152 | 768 (67) | 94 | 8.2 | 12.2 | |||
Mentzelopoulos, 2013 [30] | 268 | 149 (56) | 0 | 0 | 0 | |||
Mulder, 2014 [31] | 154 | 78 (51) | 8 | 5.2 | 10.3 | |||
Nielsen, 2013 [32] | 939 | 411 (44) | 18 | 1.9 | 4.4 | |||
Peberdy, 2003 [33] | 14,720 | 12,217 (83) | 1177 | 8.0 | 9.6 | 159 | 13.5 | 1.3 |
Rundgren, 2010 [34] | 95 | 43 (45) | 3 | 3.2 | 7.0 | 3 | 100 | 3.2 |
Sivaraju, 2015 [35] | 100 | 71 (71) | 7 | 7.0 | 9.9 | |||
Stammet, 2009 [36] | 45 | 22 (49) | 3 | 6.7 | 13.6 | |||
Total c-CPR
|
22,744
|
17,256 (75.9)
|
1694
|
5.4 [3.9–7.1]
|
8.3 [6.5–10.4]
|
185
|
59.2 [18.0–95.7] |
4.8 [0.4–11.5]
|
e-CPR
| ||||||||
Avalli, 2012 [37] | 42 | 31 (73.8) | 12 | 28.6 | 38.7 | 5 | 41.7 | 16.1 |
Fagnoul, 2013 [38] | 24 | 18 (75.0) | 5 | 20.8 | 27.8 | 1 | 20 | 5.6 |
Lamhaut, 2013 [39] | 7 | 6 (85.7) | 3 | 42.9 | 50 | 2 | 66.7 | 33.3 |
Le Guen, 2011 [40] | 51 | 49 (96.1) | 10 | 19.6 | 20.4 | |||
Massetti, 2005 [41] | 40 | 32 (80) | 15 | 37.5 | 46.9 | |||
Megarbane, 2007 [42] | 17 | 14 (82.4) | 1 | 5.9 | 7.1 | |||
Megarbane, 2011 [43] | 66 | 65 (98.5) | 6 | 9.1 | 9.2 | 3 | 50 | 4.6 |
Pozzi, 2016 [44] | 68 | 62 (91.2) | 14 | 20.6 | 22.6 | 0 | 0 | 0 |
Rousse, 2015 [45] | 32 | 30 (93.8) | 9 | 28.1 | 30 | |||
Thiagarajan, 2009 [46] | 297 | 216 (72.7) | 61 | 20.5 | 28.2 | |||
Total e-CPR
|
644
|
523 (81.2)
|
136
|
21.9 [16.6–27.5]*
|
27.9 [19.7–36.6]*
|
11
|
29.4 [4.3–60.8]
|
7.6 [0.5–17.8]
|
Overall
|
23,388
|
17,779 (76.0)
|
1830
|
8.9 [7.0–11.0]
|
12.6 [10.2–15.2]
|
196
|
41.8 [20.2–51.0]
|
5.8 [2.1–10.9]
|