According to statistics, more than half of patients who have undergone cardiopulmonary
resuscitation (CPR) die from acute cardiovascular or cerebral insufficiency caused by
global ischemia. The survival rate after cardiac arrest and successful CPR is about 10%,
with good neurological recovery from 0.9% to 7.8%.
The most common cause of cardiac arrest is heart failure, followed by respiratory
failure. Despite progress in the provision of specialized medical care, the proportion of
patients who underwent post cardiac arrest syndrome (PCAS) and discharged from the
hospital remains very low, and neurological and mental disorders persist forever.
The prevalence of nosocomial cardiac arrest in adults varies, with an average of 6 to 9
cases per 1000 hospitalizations. The prevalence of nosocomial cardiac arrest in adults
varies, with an average of 6 to 9 cases per 1000 hospitalizations. About half of
inpatient cardiac arrests occur in specialized wards, and the remaining half in other
locations, such as intensive care units (ICU) and operating rooms. Common causes of
cardiac arrest include coronary artery disease, pulmonary embolism, poisoning with
cardiotoxic agents (drugs, antidepressants, cardiac glycosides), metabolic disorders
(most often hypo- or hyperkalemia), and sepsis.
Modern methods of intensive care of PCAS provide good results, but require significant
diagnostic, therapeutic, human and economic resources. The recommendations of the
European Resuscitation Council and the European Intensive Care Society on
post-resuscitation care have had an impact on improving the quality of care. In Russia,
such recommendations are not accepted. One of the conditions for the development and
implementation of methods aimed at increasing the survival rate of patients with PCAS is
the collection of up-to-date information on the prevalence, causes and patterns of the
development of the disease.
In recent years In Russia, not a single multicenter study has been published on the
statistics of survival after cardiac arrest and the results of intensive care. There is
also no single algorithm for the treatment of post cardiac arrest syndrome, with the
exception of the organ donation protocol; meanwhile, the majority of patients suffering
from severe multiple organ failure in the postresuscitation period cannot be donors and
die as a result of the progression of multiple organ failure.
Targeted therapy for PCAS includes respiratory and hemodynamic support, temperature
management, laboratory monitoring, and anticonvulsant therapy. Predicting the degree of
neurocognitive dysfunction remains a clinically difficult issue.
The study of PCAS is undoubtedly relevant and can help identify a number of additional
prognostic factors affecting the outcome of the disease.
The purpose of this study is to examine the prevalence of PCAS in Russia, to analyze the
effectiveness of intensive care methods, to evaluate the factors associated with death
and the development of severe neurological deficits. Research centers are located on the
intensive care units. A multicenter retrospective registry cohort study is planned.
The research centers are located on the basis of the ICU, of the Irkutsk Regional
Clinical Hospital, Irkutsk City Clinical Hospital No.1, City Clinical Hospital No.3,
Irkutsk; Federal research and clinical center of intensive care medicine and
rehabilitology, Moscow; Orenburg regional clinical hospital, Orenburg City N.I. Pirogov
Clinical Hospital, Orenburg; Kuzbass Clinical Emergency Hospital named after M.A.
Podgorbunsky, Kemerovo; Regional clinical hospital, Krasnoyarsk interdistrict clinical
hospital of emergency medical care named after NS Karpovich, Krasnoyarsk interdistrict
clinical hospital №20 named after I.S. Berzona, Krasnoyarsk interdistrict clinical
hospital №4, Krasnoyarsk.
Against the background of the assessment of vital functions, methods of respiratory
support, laboratory data, and drug therapy will be compared. Continuous data will be
presented as the median and interquartile range for the nonparametric distribution and as
the mean and standard deviation for the parametric distribution. The categorical
variables will be presented as the number of patients and the percentage of the total
number of patients. For record keeping, an individual registration card.