Modifications to advanced life support in renal failure.
The outcome of cardiopulmonary resuscitation (CPR) has been reported to be worse in patients with renal failure compared with those with normal renal function. It is likely that this increased mortality may be at least partly attributable to sub-optimal and highly variable treatment strategies used in cardiac arrest in patients with renal failure, but this issue has not previously been explored. Such patients undoubtedly pose a challenge to advanced life support (ALS) providers, and renal unit staff are not trained to provide specialist advice after a patient has sustained a cardiac arrest. There are few studies investigating the epidemiology, safety or outcome of cardiac arrest in patients with renal failure and there are no generally accepted resuscitation guidelines for this special circumstance. In this article we discuss the unique problems of resuscitating patients with renal failure and propose a suitable management strategy.
Alfonzo
Annette V M
AV
Renal Unit, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife, Scotland, KY12 0SU, United Kingdom. annette.alfonzo@faht.scot.nhs.uk
Simpson
Keith
K
Deighan
Chris
C
Campbell
Stewart
S
Fox
Jonathan
J
D016223:Advance Directives; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000628:therapy; D001294:Attitude to Health; D016887:Cardiopulmonary Resuscitation; D004554:Electric Countershock; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy; D016414:Resuscitation Orders; D012307:Risk Factors