Surviving in-hospital cardiac arrest among adults with COVID-19

When an adult with the coronary vascular disease has an in-hospital cardiac arrest, survival rates are low. A new clinical trial suggests that giving patients the COVID-19 vaccine may improve survival after in-hospital cardiac arrest among adults with coronary vascular disease and asymptomatic heart failure. Learn more about how to survive cardiac arrest among adults with COVID-19 by following these steps.

What's a cardiac arrest?

Every year, over 400,000 people experience sudden cardiac arrest in U.S. hospitals (CMS, 2010). Cardiac arrest is a serious and potentially life-threatening medical emergency that occurs when your heart suddenly stops beating and blood stops flowing to your organs and brain (NIH, n.d.). A properly trained healthcare team can save your life by quickly starting CPR (cardiopulmonary resuscitation) and using an automated external defibrillator (AED) if one is available on site.

Define cardiac output

Cardiac output is defined as how much blood a ventricle can pump out of one beat (stroke volume). It is a function of both stroke volume and heart rate, which are affected by numerous conditions like cardiac diseases and medications.

Cardiac muscle is predominantly responsible for maintaining proper blood circulation throughout your body, but improper functioning can lead to many potentially life-threatening problems.

Some signs of poor cardiac output include: dizziness or fainting, shortness of breath at rest, fatigue or lethargy, weakness and shaking limbs; feeling chilled or cold despite having a normal temperature; lack of appetite/thirst or not being able to keep food down.

What are the signs of Cardiac Arrest?

A cardiac arrest is a life-threatening event that can occur suddenly, without warning. It is caused by a disturbance of your heart’s rhythm. When your heart beats irregularly or stops beating, blood doesn’t get to parts of your body. Because oxygen isn’t delivered to cells, they begin to die within minutes. If cardiac arrest is not treated immediately, death occurs soon after.

A surprising number of people suffer from sudden cardiac arrest each year. According to data collected by AHA and published online by PLOS ONE, more than 1 million Americans will experience sudden cardiac arrest each year. More than 90 percent are out-of-hospital events and nearly 90 percent result in death at the scene or shortly after emergency help arrives.

Survive an In-Hospital Cardiac Arrest

Survival after an in-hospital cardiac arrest is rare. But if it does happen, we have to wonder: what are survivors experiencing? That’s where COVID-19 comes into play. Last year, researchers released a study comparing those who survived a cardiac arrest and those who didn’t. However, due to lack of detail regarding muscle function after cardiac arrest, some research experts are skeptical as to how helpful it actually is—but its existence means that more research could follow.

Skeletal muscle function is key to survival after IHCAs and has long been a concern for researchers. After all, skeletal muscle contractions are essential to initiate cardiopulmonary resuscitation (CPR) and return blood flow following cardiac arrest. Without these muscle movements, CPR may not work as effectively. That’s why researchers have looked into myosin light chain kinase (MLCK) activity after an IHCA.

Skeletal muscle is made up of two muscles: striated and smooth. Striated muscles are also known as skeletal muscles, and they’re active muscles used for movement. Smooth muscles make up things like our stomachs, intestines, and bladder—or what are called visceral muscles. After a serious injury or heart attack that causes cardiac arrest, damaged smooth muscle can’t contract properly because something called myosin light chain kinase (MLCK) doesn’t function correctly.

Skeletal muscle contraction is controlled by a motor protein called myosin and something called myosin light chain kinase (MLCK). When there’s an injury, MLCK activity increases. As skeletal muscle cells start to heal, MLCK activity decreases and normal function returns.

Saving Lives After Cardiac Arrest - How To Be A Responder

Survival after cardiac arrest is a bit like winning a golden ticket to Willy Wonka’s chocolate factory—it seems to be something of a miracle, a beautiful display of your body’s natural function that you might never have witnessed before. After someone has suffered an episode of sudden heart failure, if they are lucky enough to survive, it will take months for them to recover and regain their strength.

Research shows that you can be part of that miracle, and your actions immediately after a cardiac arrest can have a tremendous impact on whether or not someone survives. The odds are stacked against them—only about 8% of people who suffer sudden heart failure outside of the hospital survive, compared to 40% who receive CPR from a trained responder within ten minutes.

On top of that, those who do survive often end up with life-long disabilities because their hearts did not get enough oxygen during those crucial minutes when their hearts failed.

Steps to Save Someone Who Has Suffered Cardiac Arrest

If you are one of those people who have undergone heart surgery and received cardiac care, it is important to understand what measures can be taken by health providers to save you if your heart stops beating. Cardiac care consists of a chain of survival that includes: Early recognition. Patients should be assessed for risk factors, such as coronary artery disease, chest pain or pressure, history of previous heart attack, hypertension, diabetes, and smoking; all of these increase a person’s risk for cardiac arrest.

Cardiac arrest occurs when the heart stops beating. The National Registry of Cardiopulmonary Resuscitation has described that the adult cardiac chain of survival consists of: Early recognition and call for help, Cardiopulmonary resuscitation (CPR), Defibrillation, Advance life support (ALS), or advanced cardiovascular life support (ACLS). CPR is a combination of chest compressions and artificial respiration. Chest compression-only CPR can be taught to laypersons as it involves only 1 step; delivering hands-only CPR to a person in cardiac arrest can increase their chance of survival by 32%(10); where hands-only CPR does not require mouth-to-mouth breathing or airway management procedures; thus simplifying training for laypersons.

What are STEMI, Heart Attack, and MI?

STEMI or ST-elevation myocardial infarction is a type of heart attack that occurs when there is an interruption of blood flow to part of your heart muscle. It's referred to as ST-elevation because it causes changes on an electrocardiogram test called an ST-segment. STEMI occurs when a blood clot lodges itself in one of your coronary arteries and completely blocks blood flow through that artery. If you have STEMI, you are likely to experience cardiorespiratory arrest. Cardio refers to your heart, and respirations mean breathing; cardiorespiratory arrest means you stop breathing, meaning no oxygen reaches your organs (including your brain). When a person has cardiorespiratory arrest due to a heart attack, survival rates are very low—around 4%. That said, immediate treatment can double survival rates for people who experience cardiorespiratory arrest.

How do you know if someone needs CPR?

If you think someone is going into shock, call 9-1-1 immediately. If someone has a suspected heart attack, don’t wait for 9-1-1 to arrive. Call an ambulance and then administer CPR while you wait. The most effective way to do CPR is by following instructions from your local ambulance service or fire department and following these two steps: 1) Call 911 and 2) Compress (push down on) the chest at least 100 times at a rate of 100 per minute and 15 presses per second. Keep doing it until help arrives, so it should be about 15 minutes total for every compression delivered after dialing 9-1-1 and up until medical professionals take over care.