Tailor heart therapy, medics told

The study says most in-hospital cardiac arrests are breathing related

Doctors should tailor the treatment they give to cardiac arrest patients in hospital, a study suggests.

A team from the US National Registry of CPR said doctors should focus more on treating breathing problems.

Its analysis of nearly 38,000 patients found the cardiac arrest of people in hospital was more likely to be related to breathing than heart rhythm.

The study in the Journal of American Medical Association says most hospital cases are assumed to be rhythm-related.

It says this is because most cardiac arrests which occur out of hospital are related to arrhythmia, an abnormal heart rhythm which can halt the flow of blood from the heart.

This suggests that CPR may currently succeed more often than physicians commonly believe Vinay Nadkarni, Lead researcher

But the findings suggest progressive respiratory failure and shock is a more common cause for patients in hospital.

CPR, or cardiopulmonary resuscitation, focuses on both breathing and cardiac massage to treat cardiac arrest patients.

Lead researcher Vinay Nadkarni said: "Our results suggest that hospital caregivers need to carefully tailor their resuscitations to a patient's situation, not follow blanket protocol."

But Dr Nadkarni also said doctors should be aware that children could still suffer arrhythmia, despite most assuming it is extremely rare among children.

The team found that of the 880 children seen with cardiac arrest, one in four had suffered the condition at some point.

Research 'hard'

Children were also more likely to survive, with 27% eventually being discharged from hospital compared with 18% of adults.

"These survival rates are much better than those occurring in cardiac arrests outside of hospitals," Dr Nadkarni said.

"This suggests that CPR may currently succeed more often than physicians commonly believe."

Professor Peter Weissberg, medical director of the British Heart Foundation, said the study was important because it was "hard" to carry out research in the area.

But he said most UK doctors would be aware that breathing problems were more likely to cause cardiac arrest.

"It is not all together surprising that hospital arrests are due to different causes than out-of-hospital arrests, since hospitals are dealing with an inherently sick population often with multiple problems."

He said that people who suffered cardiac arrest outside hospital mainly did so "as a result of a sudden rhythm disturbance in the context of an otherwise healthy body".