PhD defence L. (Loes) Mandigers

Dissertation in short:

This research showed a mortality rate of 56% in patients admitted to the intensive care unit (ICU) after out-of-hospital cardiac arrest (OHCA) and 59% after in-hospital cardiac arrest (IHCA).The mortality rates of OHCA patients declined over the years, in IHCA these numbers did not change. Less women are admitted to the ICU after cardiac arrest than men. However, mortality rates in the first year after cardiac arrest are higher in women than in men. A heart-lung bypass machine can be used during cardiopulmonary resuscitation. Using this, the organs can be supplied with oxygen while the cause of the arrest can be found and treated, this is called extracorporeal cardiopulmonary resuscitation (ECPR). The time of low oxygen transport during resuscitation will be an important determining factor in post-resuscitation outcomes. Using ECPR short term survival will be better after longer resuscitation durations than without using ECPR. ECPR can also be important if the cardiac arrest is caused by a pulmonary embolism. During cardiac arrest, the level of oxygen in the skin declines rapidly. After initiation of ECPR there is a delay in retrieving oxygen levels in the skin. When this oxygen level in the brain is higher in the first 30 minutes after ECPR initiation, this will result in more favourable outcomes than in patients with lower oxygen levels. No differences in outcomes were found in changes of carbon dioxide levels.