[Cardiopulmonary resuscitation in COVID-19 patients]

Argento F, Díaz A, Alcaraz A, Alfie V, Colaci C, Donato M, Pichon-Riviere A, Augustovski F, Bardach A, García Martí S, Ciapponi A
Record ID 32018002327
Original Title: Reanimación cardiopulmonar en pacientes con COVID-19
Authors' recommendations: No studies assessing the use of Personal Protection Equipment (PPE) in Cardiopulmonary Resuscitation (CPR) have been found in terms of results such as mortality, resuscitation success rate, infection rate in the treating team or time to CPR initiation. Very low-quality evidence, because it is indirect or at risk of bias, does not allow to draw conclusions on the impact of the use of the PPEs recommended during CPR maneuvers (gown, N95 respirator mask, eye protection and gloves). However, this evidence suggests that the use of PPE might result in less accuracy during the maneuver and increased fatigue in the healthcare providers performing it. Nevertheless, most of this evidence comes from simulated clinical trials and the use of PPE measures that are not those used to prevent aerosolization in COVID-19. The studies consulted, which assess the ethical issues related to performing CPR in COVID-19 indicate that damage versus benefit should be considered when using these maneuvers; where damage should not only consider potential transmission to Healthcare providers, but also the impact this transmission may have on the Health system. In turn, they mention that the benefit of CPR would be less significant in COVID-19 patients, since most of the studies showed a higher mortality after performing CPR in this population. The recommendations of the Argentine Society of Cardiology, in agreement with Argentina’s Ministry of Health, as well as the Latin American Consensus on Cardiopulmonary Resuscitation, the European Council Resuscitation Guidelines, the International Liaison Committee on Resuscitation, the American Heart Association and the Resuscitation Council UK have determined that healthcare providers should wear PPE against aerosolization (level 3) prior to initiating CPR. Some of the consulted societies consider the use of level 2 PPE (against droplets) during defibrillation and highlight the importance of early intubation to reduce the risk of aerosolization and recommend performing a video laryngoscopy to reduce the risk of transmission among professionals.
Project Status: Completed
Year Published: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Personal Protective Equipment
  • COVID-19
  • SARS-CoV-2
  • Coronavirus Infections
  • Cardiopulmonary Resuscitation
  • Emergency Medical Services
  • Emergency Responders
  • Emergency Medical Technicians
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.