Cardiopulmonary resuscitation in obese patients: a scoping review
Considine, Julie Couper, Keith Greif, Robert Ong, Gene Yong-Kwang Smyth, Michael A Ng, Kee Chong Kidd, Tracy Mariero Olasveengen, Theresa Bray, Janet
Considine, Julie
Couper, Keith
Greif, Robert
Ong, Gene Yong-Kwang
Smyth, Michael A
Ng, Kee Chong
Kidd, Tracy
Mariero Olasveengen, Theresa
Bray, Janet
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Affiliation
Deakin University; Centre for Quality and Patient Safety in the Institute for Health Transformation; Centre for Quality and Patient Safety Research - Eastern Health Partnership; University of Warwick; University Hospitals Birmingham NHS Foundation Trust; University of Torino; University of Bern; Duke-NUS Medical School; KK Women's and Children's Hospital; Bendigo Health; LaTrobe University; Oslo University Hospital; University of Oslo; Monash University; Curtin University
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Publication date
2024-11-15
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Abstract
Background: Given the increasing global prevalence of obesity, the International Liaison Committee on Resuscitation (ILCOR) commissioned this scoping review to explore current evidence underpinning treatment and outcomes of obese patients (adult and children) in cardiac arrest.
Methods: This scoping review, conducted using Arksey and O'Malley's framework and reported according to PRISMA-ScR guidelines, included studies of CPR in obese patients. 'Obese' was defined according to each individual study. Medline, EMBASE and Cochrane were searched from inception to 1 October 2024. Narrative synthesis was guided by Synthesis Without Meta-Analysis (SWiM) reporting guidelines.
Results: 36 studies were included: 2 paediatric and 34 adult studies. Fourteen studies reported on out-of-hospital cardiac arrest (OHCA), 12 on in-hospital cardiac arrest (IHCA), eight on both OHCA and IHCA: cardiac arrest location was not reported in two studies. The most common outcomes were survival (n = 29), neurological outcome (n = 17) and ROSC (n = 7). In adults there were variable results in neurological outcome, survival to hospital discharge, longer term survival (months to years), and ROSC. In children, there were two studies suggesting that obese children had worse neurological outcomes, lower survival and lower ROSC than normal weight children. Few studies reported resuscitation quality indicators or techniques, and no studies reported adjustments to CPR techniques.
Conclusion: The variability in results does not suggest an urgent need to deviate from standard CPR protocols, however there was some evidence that CPR duration may be longer in obese adults, which may have staffing and resource implications.
Citation
Considine J, Couper K, Greif R, Ong GY, Smyth MA, Ng KC, Kidd T, Mariero Olasveengen T, Bray J; International Liaison Committee on Resuscitation (ILCOR) Basic Life Support (BLS), Advanced Life Support (ALS), Paediatric Life Support (PLS), and Education, Implementation, Teams (EIT) Task Forces. Cardiopulmonary resuscitation in obese patients: A scoping review. Resusc Plus. 2024 Nov 15;20:100820. doi: 10.1016/j.resplu.2024.100820.
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Article