Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Pneumonia patients at risk for in-hospital cardiac arrest

16.05.2011
Hospital patients with pneumonia may be at risk of experiencing sudden cardiac arrest, often with few or no warning signs, according to research from the University of Chicago Medical Center under the auspices of the American Heart Association's Get with the Guidelines project.

The results of the study will be presented at the American Thoracic Society's 2011 International Conference in Denver.

"We found a compelling signal that some patients with pneumonia may develop cardiac arrest outside of the ICU, without apparent shock or respiratory failure," said lead investigator Gordon Carr, MD, pulmonary and critical Care fellow, at the University of Chicago Medical Center. "If this is true, then we need to improve how we assess risk in pneumonia."

Dr. Carr and colleagues used a large registry of in-hospital cardiac arrest (IHCA) from the American Heart Association's Get with the Guidelines database to examine the characteristics of early cardiac arrest in patients with pre-existing pneumonia. Of 44,416 cardiopulmonary arrest events that occurred within 72 hours of hospital admission that had complete data, 5,367 (12.1 percent) occurred in patients with pre-existing pneumonia. Among those patients with pneumonia, almost 40 percent of cardiac arrests occurred outside of an intensive care unit. Furthermore, at the time of cardiac arrest, only 40 percent of patients with preexisting pneumonia were receiving mechanical ventilation, and 36.3 percent were receiving infusions of vasoactive medications. The distribution of patients with early IHCA was similar in the ICU and in the general ward. Survival was poor for all groups with early in hospital cardiac arrest.

"While our study design precluded definitive analyses of incidence or cause and effect, our main finding was that some patients with pneumonia and cardiac arrest did not appear to experience a premonitory period of overt critical illness," said Dr. Carr. "There appears to be an important group of patients with pneumonia who develop cardiac arrest without respiratory failure or shock."

This is the first large study to report the characteristics of in-hospital cardiopulmonary arrest among patients with pneumonia. The finding that many of these patients are not receiving intensive care or interventions suggests that patients with pneumonia are either more vulnerable than previously thought to abrupt deterioration or that the triage methods used to determine whether a patient is in need of intensive care may be inadequate for patients with pneumonia.

"Decisions about ICU admission may need to be more proactive rather than reactive," Dr. Carr noted. "If we focus our intensive care resources on patients with obvious shock and respiratory failure, we may miss opportunities to intervene on other patients who are at high risk for abrupt deterioration.

"Future studies should investigate the incidence and causes of sudden, early cardiovascular collapse in patients with pneumonia and other forms of sepsis, and address ways to measure and mitigate this risk," he continued. "In the meantime, physicians need to be alert to the possibility of abrupt transitions in these patients."

Finally, Dr. Carr suggested that these findings indicate a need for more research on the different phenotypes of sepsis, of which pneumonia is a major cause. "In recent years we have been lumping these patients into one big group, to facilitate research and the dissemination of care 'bundles'," he said. "In clinical reality, pneumonia and sepsis may be very heterogeneous, and patients who die from these diseases may follow different trajectories. Accordingly, we may need different risk assessment and therapeutic tools for different subgroups."

"In-Hospital Cardiac Arrest Among Patients With Coexisting Pneumonia: A Report From The American Heart Association's Get With The Guidelines - Resuscitation Program" (Session A20, Sunday, May 1, 8:15-10:45 a.m., MDT, Room 102-104-106 (Street Level), Colorado Convention Center; Abstract 22539)

Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.

Keely Savoie | EurekAlert!
Further information:
http://www.thoracic.org

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

Climate change: In their old age, trees still accumulate large quantities of carbon

17.08.2017 | Earth Sciences

Modern genetic sequencing tools give clearer picture of how corals are related

17.08.2017 | Life Sciences

Superconductivity research reveals potential new state of matter

17.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>