Cardiac Arrest in the Intensive Care Unit

  • J. Tirkkonen
  • I. Efendijev
  • M. B. SkrifvarsEmail author
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


Most in-hospital cardiac arrests (IHCAs) occur on normal general wards due to non-cardiac etiology, and the prognosis is poor with only one fifth of IHCA patients surviving to hospital discharge [1–3]. Studies from the last two decades have repeatedly highlighted the presence of abnormal vital signs preceding a clear majority of IHCAs [4, 5]. This explains the poor survival even when immediate advanced cardiac life support is provided; if the cardiac arrest occurs after hours of continuous hemodynamic and respiratory instability, efforts to recover spontaneous circulation do not solve the core problem [6]. Therefore, in-hospital advanced cardiac life support programs have shifted towards the prevention of cardiac arrest in general wards through use of rapid response systems [7]. A multitude of before-after trials have shown that IHCAs (and indeed also in-hospital deaths) may be avoided through early detection of deteriorating vital signs and timely transfers to intensive care [8].


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Intensive Care Medicine and Department of Emergency, Anesthesia and Pain MedicineTampere University HospitalTampereFinland
  2. 2.Division of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain MedicineUniversity of Helsinki and HUS Helsinki University HospitalHelsinkiFinland
  3. 3.Department of Emergency Care and ServicesUniversity of Helsinki and HUS Helsinki University HospitalHelsinkiFinland

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