Citation

Lacoste-Palasset T, Megarbane B, Deye N. Resuscitation 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.resuscitation.2022.04.022

PMID

35489520

Abstract

Cardiac arrest (CA) is a major health problem, whatever the causative mechanism, with ischemic heart disease remaining the leading cause of mortality worldwide, accounting for roughly 13% of deaths. Besides sudden CA related to unexpected non-traumatic lethal event, CA from extra-cardiac origin is mainly secondary to fatal traumatism, drowning, electrocution, external asphyxia, and drug overdose or poisoning. Although less investigated than CA from cardiac origin, poisoning-related cardiac arrest (P-CA) is a major cause of death in young adults. Whereas poisoning rarely causes CA, exposures to toxic agents with the most severe outcomes including death have increased since 2000. Proportion of out-of-hospital P-CA slightly varies between countries, accounting from 1-3% in Germany, Korea, and Taiwan to 7% in Australia. By contrast, causative agents differ markedly, with predominance of psychotropic drugs intoxication in Western countries (including sedative, alcohol, street drug, and opioids as the first cause of drug-related fatalities), compared to pesticides including organophosphate more frequently observed in Asia or Maghreb regarding their prognosis, conflicting findings are reported, supporting P-CA either as an independent factor of better in-hospital survival, such as opioid overdose-related CA, or as associated with similar survival but more evolution to brain death. These discrepancies, probably related to the different categories of toxicants responsible for P-CA, explain highly variable survival rate and neurological outcome depending on regions and type of intoxications...

Language: en