CAPE TOWN – A recent study published in JAMA Internal Medicine found that 100% of Covid-19 patients that underwent CPR died.
As severe cases of Covid-19 may cause breathing and cardiac complications, the study, raised a bigger question on the risks of performing cardiopulmonary resuscitation (CPR) which exposes medical personnel to the virus, while limited supplies of personal protective equipment (PPE) are available globally.
Between 15 March and 3 April 2020, 1309 patients diagnosed with Covid-19 were admitted to Beaumont Health hospital in Michigan with the team of researchers identifying patients who underwent CPR for cardiac arrest. The research aimed to then identify the initial cardiac arrest rhythm, time to return of spontaneous circulation (ROSC), and overall survival to discharge.
The researchers identified 54 Covid-19 patients who underwent CPR, 52 of those patients had non-shockable rhythms and 44 with pulseless cardiac electrical activity and two patients had an abnormally fast heart rhythm called pulseless ventricular tachycardia. Despite CPR achieved 29 (53.7 percent) of the patients the return of spontaneous circulation (ROSC) after a median of 8 minutes, none of them survived.
15 patients from the 29 who had achieved a return of spontaneous circulation had their code status changed to do not resuscitate with 14 undergoing additional CPR; all patients died.
The researchers acknowledged in the study report that there may be many factors contributing to the poor outcomes of CPR on Covid-19 patients with most developing a non-shockable rhythm and many requiring mechanical ventilation, kidney replacement therapy or vasopressor support with only a 30-day survival rate of 2.9 percent.
The study concludes with the researchers believing their findings warrant further investigation into the risks of CPR on Covid-19 patients as well as medical staff with weighing up the low success rate with the chance of high Covid-19 transmission.
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