Pulseless electrical activity natural history, complications and prognosis: Difference between revisions
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{{Pulseless electrical activity}} | {{Pulseless electrical activity}} | ||
{{CMG}}; {{AE}} {{KGH}} | |||
==Overview== | |||
PEA is associated with a poor prognosis, particularly if the underlying cause is not readily identified and treated. The presence of a [[QRS interval]] > 0.20 seconds is associated with a poorer prognosis. The survival of patients with PEA as a presenting rhythm for [[sudden cardiac arrest]] is poorer than [[ventricular tachycardia]] or [[ventricular fibrillation]].<ref name="pmid19770741">{{cite journal | author = Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA | title = Rhythms and outcomes of adult in-hospital cardiac arrest | journal = Critical Care Medicine | volume = 38 | issue = 1 | pages = 101–8 | year = 2010 | month = January | pmid = 19770741 | doi = 10.1097/CCM.0b013e3181b43282 | url = http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=38&issue=1&spage=101 | issn = | accessdate = 2012-09-16}}</ref> | |||
== | ===Natural History=== | ||
*The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___. | |||
*The symptoms of (disease name) typically develop ___ years after exposure to ___. | |||
*If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3]. | |||
===Complications=== | |||
*Common complications of [disease name] include: | |||
**[Complication 1] | |||
**[Complication 2] | |||
**[Complication 3] | |||
===Prognosis=== | ===Prognosis=== | ||
*Prognosis is generally poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%. | |||
*Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent. | |||
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy]. | |||
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis. | |||
==Natural History, Complications and Prognosis== | |||
* The survival of patients with out of hospital occurrence of PEA is 19.5% compared to 11.2% among patients with in hospital PEA, likely due to the higher incidence of reversible causes among patients with out of hospital arrest.<ref name="pmid19770741">{{cite journal | author = Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA | title = Rhythms and outcomes of adult in-hospital cardiac arrest | journal = Critical Care Medicine | volume = 38 | issue = 1 | pages = 101–8 | year = 2010 | month = January | pmid = 19770741 | doi = 10.1097/CCM.0b013e3181b43282 | url = http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0090-3493&volume=38&issue=1&spage=101 | issn = | accessdate = 2012-09-16}}</ref><ref name="pmid23454257">{{cite journal |vauthors=Thomas AJ, Newgard CD, Fu R, Zive DM, Daya MR |title=Survival in out-of-hospital cardiac arrests with initial asystole or pulseless electrical activity and subsequent shockable rhythms |journal=Resuscitation |volume=84 |issue=9 |pages=1261–6 |date=September 2013 |pmid=23454257 |pmc=3947599 |doi=10.1016/j.resuscitation.2013.02.016 |url=}}</ref><ref name="pmid22406930">{{cite journal |vauthors=Teodorescu C, Reinier K, Uy-Evanado A, Ayala J, Mariani R, Wittwer L, Gunson K, Jui J, Chugh SS |title=Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: the Oregon Sudden Unexpected Death Study |journal=J Interv Card Electrophysiol |volume=34 |issue=3 |pages=219–25 |date=September 2012 |pmid=22406930 |pmc=3627722 |doi=10.1007/s10840-012-9669-2 |url=}}</ref> | |||
* Among 11,963 patients with PEA, only 11% survived, 62% of which had good neurological outcomes.<ref name="pmid16391216">{{cite journal| author=Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME et al.| title=First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. | journal=JAMA | year= 2006 | volume= 295 | issue= 1 | pages= 50-7 | pmid=16391216 | doi=10.1001/jama.295.1.50 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16391216 }} </ref> | |||
According to | * According to the Resuscitation Outcomes Consortium, the survival of patients with [[SCA]] during hospitalization is 8% among subjects with PEA compared to 30.5% for subjects with [[VT]] or [[VF]]; therefore, strategies for improving survival after PEA due to SCA should be implemented. | ||
==References== | ==References== | ||
Latest revision as of 12:01, 21 May 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]
Overview
PEA is associated with a poor prognosis, particularly if the underlying cause is not readily identified and treated. The presence of a QRS interval > 0.20 seconds is associated with a poorer prognosis. The survival of patients with PEA as a presenting rhythm for sudden cardiac arrest is poorer than ventricular tachycardia or ventricular fibrillation.[1]
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
- Common complications of [disease name] include:
- [Complication 1]
- [Complication 2]
- [Complication 3]
Prognosis
- Prognosis is generally poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
- Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
Natural History, Complications and Prognosis
- The survival of patients with out of hospital occurrence of PEA is 19.5% compared to 11.2% among patients with in hospital PEA, likely due to the higher incidence of reversible causes among patients with out of hospital arrest.[1][2][3]
- Among 11,963 patients with PEA, only 11% survived, 62% of which had good neurological outcomes.[4]
- According to the Resuscitation Outcomes Consortium, the survival of patients with SCA during hospitalization is 8% among subjects with PEA compared to 30.5% for subjects with VT or VF; therefore, strategies for improving survival after PEA due to SCA should be implemented.
References
- ↑ 1.0 1.1 Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA (2010). "Rhythms and outcomes of adult in-hospital cardiac arrest". Critical Care Medicine. 38 (1): 101–8. doi:10.1097/CCM.0b013e3181b43282. PMID 19770741. Retrieved 2012-09-16. Unknown parameter
|month=ignored (help) - ↑ Thomas AJ, Newgard CD, Fu R, Zive DM, Daya MR (September 2013). "Survival in out-of-hospital cardiac arrests with initial asystole or pulseless electrical activity and subsequent shockable rhythms". Resuscitation. 84 (9): 1261–6. doi:10.1016/j.resuscitation.2013.02.016. PMC 3947599. PMID 23454257.
- ↑ Teodorescu C, Reinier K, Uy-Evanado A, Ayala J, Mariani R, Wittwer L, Gunson K, Jui J, Chugh SS (September 2012). "Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: the Oregon Sudden Unexpected Death Study". J Interv Card Electrophysiol. 34 (3): 219–25. doi:10.1007/s10840-012-9669-2. PMC 3627722. PMID 22406930.
- ↑ Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME; et al. (2006). "First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults". JAMA. 295 (1): 50–7. doi:10.1001/jama.295.1.50. PMID 16391216.