CAO Recovered in the General Intensive Care Unit: Epidemioclinical Characteristics and Mortality Factors in a Sub-Saharan African Country

Chake Maria Josiane  Bekoin-Abhe; Goulai Bi You  Etienne Bazago; Coulibaly Klinna Théodore; Mobio Michael Paterne; Bedié Yao Vianney

doi:10.18502/aacc.v10i1.14768

Chake Maria Josiane Bekoin-Abhe Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire.
Goulai Bi You Etienne Bazago Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire.
Coulibaly Klinna Théodore Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire.
Mobio Michael Paterne Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire.
Bedié Yao Vianney Multipurpose Intensive Care Unit of Cocody University Hospital, Cocody, Abidjan, Côte d'Ivoire.

DOI: https://doi.org/10.18502/aacc.v10i1.14768

Keywords: Cardiac arrest; Operating room; Resuscitation; Mortality

Abstract

Background: Cardiac arrest in the operating room (CAO) is a serious accident of often rare epidemiology.

Methods: Retrospective, descriptive and analytical study from 2012 to 2021 in the multipurpose intensive care unit of the Cocody University Hospital in Abidjan, including all patients who presented a recovered CAO.

Results: The prevalence was 1.5% (89 out of 5730 admissions). The mean age was 33.5 ± 26 years (13-81). The sex ratio was 0.1. The medical history was mostly hypertension (22.5%). Patients were classified ASA ≥ III (52.8%) for urgent surgery (52.8%) under spinal anesthesia (56.6%). CAO occurred mostly at anesthetic induction (44.3%). The causes were mainly persistent arterial hypotension (54.7%) and hemorrhagic shock (30.2%). Medical CPR was performed in 94.8% of cases in the operating room before transfer to the intensive care unit. The mean duration of LowFlow was 4.5±1.8 minutes (3-12). On admission, the mean Glasgow score was 6.3±4.4 (3-11). Treatment consisted of continued CPR. The mean stay was 3.1±2.9 minutes (1-12). The death rate was 60.4%. ASA class >3, urgent procedure, general anesthesia, presence of NA alone, Gl score ≤ 7, and Low Flow duration> 5 minutes were predictive of mortality (p < 0.05).

Conclusion: strengthening of material resources and continuous training in extreme emergency situations for anesthesia personnel could optimize the prognosis of CAO.