Association of Return of Spontaneous Circulation with the Duration of Cardiopulmonary Resuscitation in Patients Presenting to the Emergency Department of a Tertiary Care Hospital in Karachi Pakistan – A Quasi-Experimental Study

Abstract

Objective: To determine the association between the duration of Cardio-pulmonary resuscitation and the return of spontaneous circulation in cardiac arrest patients.
Study Design: A retrospective quasi-experimental study.
Place and Duration of Study:  It was carried out over a 6-month period on cardiac arrest patients presenting to the Emergency Department from June till December 2020 at Ziauddin University Hospital, Karachi, Pakistan.
Methods: A sample of 178 patients was selected through consecutive sampling.  The patients were divided into two groups each consisting of 89 participants.  The conventional group received cardio-pulmonary resuscitation for 20 minutes, while the interventional group had it for more than 20 minutes.
Results: The mean age was 59.49 years (SD ± 17.2), predominantly males. In the conventional group, 64 patients (36%) experienced recovery with a Return of Spontaneous Circulation, while in the interventional group, this was achieved in 37 patients (20.8%). Overall, among the 176 patients who received Cardio-pulmonary resuscitation, 56.7% (n = 101) achieved a Return of Spontaneous Circulation. Among these 101 patients with a Return of Spontaneous Circulation, the documented average duration of their Cardio-pulmonary resuscitation was approximately 12.17 ± 4.77 minutes, compared to 34.47 ± 7.22 minutes for patients who did not achieve a Return of Spontaneous Circulation (P < 0.0001). Similarly, the mean time of Cardio-pulmonary resuscitation initiation was statistically significantly different between the two groups (P < 0.001) using the Pearson chi-Square test.
Conclusion: Increasing the duration of Cardio-pulmonary resuscitation does not benefit patients in terms of resuscitation, recovery, or survival. Cardio-pulmonary resuscitation lasting less than 20 minutes had a higher likelihood of achieving spontaneous circulation recovery compared to that lasting for more than 20 minutes. Initiation of Cardio-pulmonary resuscitation as early as possible had better chances of recovery and survival especially when initiated immediately after cardiac arrest.