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Resuscitation after cardiac surgery: results of an international survey

^a Department of Cardiology, James Cook University Hospital, Middlesbrough, UK
^b CTSNet, The Cardiothoracic Surgery Network, World Trade Center, Baltimore, USA
^c Department of Cardiothoracic Surgery, North Staffordshire Hospital, Stoke-on-Trent, UK
^d Department of Cardiothoracic Anaesthesia, Wythenshawe Hospital, Manchester, UK
^e Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK

Received 11 November 2008; accepted 23 February 2009.

^_* Corresponding author. Tel.: +44 7801548122; fax: +44 7801548122. (Email: joeldunning{at}doctors.org.uk).

Objective: A survey was conducted on CTSNet, the cardiothoracic network website in order to ascertain an international viewpoint on a range of issues in resuscitation after cardiac surgery. Methods: From 40 questions, 19 were selected by the EACTS clinical guidelines committee. Respondents were anonymous but their location was determined by their Internet protocol (IP) address. The responses were checked for duplication and completion errors and then the results were presented either as percentages or median and range. Results: From 387 responses, 349 were suitable for inclusion from 53 countries. The median size of unit of respondents performed 560 cases per year. The incidence of cardiac arrest reported was 1.8%, emergency resternotomy after arrest 0.5% and emergency reinstitution of bypass 0.2%. Only 32% of respondents follow current guidelines on resuscitation in their unit and an additional 25% of respondents have never read these guidelines. Respondents indicated that they would perform three attempts at defibrillation for ventricular fibrillation without intervening external cardiac massage and for all arrests perform emergency resternotomy within 5 min if within 24 h of the operation. Fifty percent of respondents would give adrenaline immediately, 58% of respondents would be happy for a non-surgeon to perform an emergency resternotomy and 76% would allow a surgeon's assistant and 30% an anaesthesiologist to do this. Only 7% regularly practise for arrests, but 80% thought that specific training in this is important. Conclusion: This survey supports the EACTS guideline for resuscitation in cardiac arrest after cardiac surgery published in this issue of the journal.

Key Words: Resuscitation • Survey • Thoracic surgery • Cardiac arrest • Cardiac surgery • Emergency resternotomy

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