Cardiac arrest & resuscitation
Peri‐operative cardiac arrest due to suspected anaphylaxis as reported to the 7th National Audit Project of the Royal College of Anaesthetists
Authors' conclusion
Overall, peri-operative anaphylaxis leading to cardiac arrest occurred with a similar frequency and patterns of presentation, location, initial rhythm and suspected triggers in NAP7 as in the 6th National Audit Project (NAP6).
Study context
- Population
- Patients with peri-operative cardiac arrest due to suspected anaphylaxis reported to National Audit Project (NAP7) of the Royal College of Anaesthetists33 judged anaphylaxis
- Participants
- 59 patients
- Outcome
- Peri-operative cardiac arrest due to suspected anaphylaxis: cases confirmed by review panel and frequency in registry
Methodological detailsNAP7, baseline survey, year-long case registry, expert panel review
- NAP7
- Baseline survey
- Year-long case registry
- Expert panel review
Main finding
As reported in the abstract
Reported as possible anaphylaxis, judged anaphylaxis by review panel (high or moderate confidence)
33 (56%) of 59
Suspected anaphylaxis seventh most common cause of peri-operative cardiac arrest in year-long registry, share of reports
4%
Resuscitated successfully
All 33
Later died
1
Observational data: associations, not effects.
Further findings
Management and comparison with National Audit Project (NAP6)
- Initial management most often low-dose IV adrenaline, without complications
- Reluctance to start chest compressions when SBP <50 mmHg, occasionally even when unrecordable
- Frequency, presentation, location, initial rhythm and suspected triggers similar to NAP6
- Outcomes generally better than equivalent NAP6 cases
Original publication
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