Clinical practice recommendations on the management of perioperative cardiac arrest: A report from the PERIOPCA Consortium
Athanasios Chalkias,
Nicolas Mongardon,
Vladimir Boboshko,
Vladimir Cerny,
Anne-Laure Constant,
Quentin De Roux,
Gabriele Finco,
Francesca Fumagalli,
Eleana Gkamprela,
Stéphane Legriel,
Vladimir Lomivorotov,
Aurora Magliocca,
Panagiotis Makaronis,
Ioannis Mamais,
Iliana Mani,
Theodoros Mavridis,
Paolo Mura,
Giuseppe Ristagno,
Salvatore Sardo,
Nikolaos Papagiannakis,
Theodoros Xanthos,
for the PERIOPCA Consortium
Affiliations
Athanasios Chalkias
Department of Anesthesiology, Faculty of Medicine, University of Thessaly
Nicolas Mongardon
Service D’anesthésie-Réanimation Chirurgicale, DMU CARE, DHU A-TVB, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Faculté de Santé
Vladimir Boboshko
Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center
Vladimir Cerny
Department of Anesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University
Anne-Laure Constant
Service D’Anesthésie Et Réanimation, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris
Quentin De Roux
Service D’anesthésie-Réanimation Chirurgicale, DMU CARE, DHU A-TVB, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Faculté de Santé
Gabriele Finco
Department of Medical Sciences and Public Health, University of Cagliari
Francesca Fumagalli
Laboratory of Cardiopulmonary Pathophysiology, Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
Eleana Gkamprela
National and Kapodistrian University of Athens, Medical School, Postgraduate Study Course (MSc) “Resuscitation”
Stéphane Legriel
Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot
Vladimir Lomivorotov
Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center
Aurora Magliocca
Laboratory of Cardiopulmonary Pathophysiology, Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
Panagiotis Makaronis
National and Kapodistrian University of Athens, Medical School, Postgraduate Study Course (MSc) “Resuscitation”
Ioannis Mamais
Department of Health Sciences, European University Cyprus
Iliana Mani
National and Kapodistrian University of Athens, Medical School, Postgraduate Study Course (MSc) “Resuscitation”
Theodoros Mavridis
1st Department of Neurology, Medical School, National and Kapodistrian University of Athens
Paolo Mura
Department of Medical Sciences and Public Health, University of Cagliari
Giuseppe Ristagno
Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Salvatore Sardo
Department of Medical Sciences and Public Health, University of Cagliari
Nikolaos Papagiannakis
1st Department of Neurology, Medical School, National and Kapodistrian University of Athens
Abstract Background Perioperative cardiac arrest is a rare complication with an incidence of around 1 in 1400 cases, but it carries a high burden of mortality reaching up to 70% at 30 days. Despite its specificities, guidelines for treatment of perioperative cardiac arrest are lacking. Gathering the available literature may improve quality of care and outcome of patients. Methods The PERIOPCA Task Force identified major clinical questions about the management of perioperative cardiac arrest and framed them into the therapy population [P], intervention [I], comparator [C], and outcome [O] (PICO) format. Systematic searches of PubMed, Embase, and the Cochrane Library for articles published until September 2020 were performed. Consensus-based treatment recommendations were created using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The strength of consensus among the Task Force members about the recommendations was assessed through a modified Delphi consensus process. Results Twenty-two PICO questions were addressed, and the recommendations were validated in two Delphi rounds. A summary of evidence for each outcome is reported and accompanied by an overall assessment of the evidence to guide healthcare providers. Conclusions The main limitations of our work lie in the scarcity of good quality evidence on this topic. Still, these recommendations provide a basis for decision making, as well as a guide for future research on perioperative cardiac arrest.
