Korean J Crit Care Med.  2009 Apr;24(1):22-27. 10.4266/kjccm.2009.24.1.22.

Infectious Complications in the Survivors of Out-of-hospital Cardiac Arrest

• Woo SH
• Lee WJ
• Choi SM
• Choi SP
• Park KN

• KMID: 2228366
• DOI: http://doi.org/10.4266/kjccm.2009.24.1.22

Abstract

BACKGROUND: Infectious complications commonly occur in the survivors of out-of-hospital cardiac arrest. The aim of our study was to describe the incidence, associated factors and outcome of infectious complications of the survivors of out-of-hospital cardiac arrest.
METHODS
We conducted a retrospective analysis of 75 patients who survived out-of-hospital cardiac arrest. We collected the data on the demographics, the modes of cardiac arrest, the duration of CPR, the dose of epinephrine, the use of hypothermia, new infections, the duration of mechanical ventilation, the length of stay in the intensive care unit (ICU), recovery of consciousness and the mortality.
RESULTS
New infections developed in 46.7% of the patients. Asystole was the most common rhythm (70.7%). The most common infectious complication was pneumonia (40.0%) urinary tract infection developed in 10 cases, vascular catheter local infection developed in 6 cases, primary blood stream infection developed in 3 cases, wound infection developed in 2 cases and pseudomembranous colitis developed in 1 case. The most common pathogens of pneumonia were Pseudomonas aeruginosa and Staphylococcus aureus. Blood cultures were obtained in 36 patients during the first 24 hr and the pathogen was isolated in three. The patients with infection had a longer duration of mechanical ventilation and a longer stay in the ICU (p < 0.001, p = 0.001).
CONCLUSIONS
Infectious complications are common in survivors of out-of-hospital cardiac arrest and these infections are associated with a longer duration of mechanical ventilation and a longer stay in the ICU. The most common infectious complication was pneumonia and the pathogens of pneumonia were Pseudomonas aeruginosa and Staphylococcus aureus.

Keyword

cardiac arrest; infection; pathogen

MeSH Terms

Cardiopulmonary Resuscitation
Consciousness
Demography
Enterocolitis, Pseudomembranous
Epinephrine
Heart Arrest
Humans
Hypothermia
Incidence
Intensive Care Units
Length of Stay
Out-of-Hospital Cardiac Arrest
Pneumonia
Pseudomonas aeruginosa
Respiration, Artificial
Retrospective Studies
Rivers
Staphylococcus
Staphylococcus aureus
Survivors
Urinary Tract Infections
Vascular Access Devices
Wound Infection
Epinephrine