Rob Dillard

DocwireNews

It&rsquo;s not necessary to consider blanket do-not-resuscitate orders for SARS-CoV-2 (COVID-19) patients because there&rsquo;s insufficient data on US survival rates and for in-hospital resuscitation, according to a new article published today in&nbsp;Circulation:&nbsp;Cardiovascular Quality and Outcomes,&nbsp;an&nbsp;American Heart Association journal.Although there is a presumption that COVID-19 patients have a low survival rate following resuscitation, that presumption comes from a recent study from Wuhan, China, that found an overall survival rate of 2.9% in almost 140 SARS-CoV-2 patients who underwent cardiopulmonary resuscitation for in-hospital cardiac arrest. 
[do_widget id=mashup_multiwidget-28] 
However, that prognosis should not be applied to the U.S., said Saket Girotra, M.D., S.M., assistant professor of medicine in the division of cardiovascular diseases at the University of Iowa Carver College of Medicine, on behalf of the American Heart Association&rsquo;s Get With The Guidelines&reg;-Resuscitation (GWTG-R) investigators in a <a href="https://newsroom.heart.org/news/no-evidence-blanket-do-not-resuscitate-orders-for-covid-19-patients-are-necessary?preview=e0ee">press release</a>.In this study, the researchers evaluated data from 2014-2018 on 5,690 patients similar to the COVID-19 population. The patients of interest underwent CPR for in-hospital cardiac arrest while being treated in an intensive care unit (ICU) for pneumonia or sepsis and were receiving mechanical ventilation at the time of cardiac arrest.While researchers noted an overall survival rate of only 12.5% in the U.S. simulation, there were many variables that could affect survival and neurologic outcomes. The probability of survival without severe neurological disability ranged from less than 3% to more than 22%, across key patient subgroups. The probability of mild to no disability ranged from about 1% to 17% across key patient subgroups.Researchers observed that survival rates were low in older and sicker patients with non-shockable heart rhythms, and survival rates were much higher (more than 20%) in younger patients with an initial shockable rhythm who were not being treated with vasopressor medications prior to the cardiac arrest. Moreover, vasopressor medications are generally used to improve blood pressure and cardiac output in emergency situations such as septic shock or cardiac arrest.&ldquo;Such large variation in survival rates suggests that a blanket prescription of do-not-resuscitate orders in patients with COVID-19 may be unwarranted. Such a blanket policy also ignores the fact that early experience of the pandemic in the U.S. reveals that a about a quarter of COVID-19 patients are younger than 50 years of age and otherwise healthy. Cardiac arrest in such patients will likely have a different prognosis,&rdquo; the researchers said, according to the release.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
No evidence blanket 'do-not-resuscitate' orders for COVID-19 patients are necessary <a href="https://twitter.com/HeartNews?ref_src=twsrc%5Etfw">@HeartNews</a> <a href="https://t.co/c52uChvBRh">https://t.co/c52uChvBRh</a>
&mdash; Medical Xpress (@physorg_health) <a href="https://twitter.com/physorg_health/status/1263866526991613953?ref_src=twsrc%5Etfw">May 22, 2020</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>&nbsp;The authors wrote in conclusion that &ldquo;&hellip; in a cohort of critically ill patients on mechanical ventilation, survival outcomes following in-hospital resuscitation were not uniformly poor. These data may help guide discussions between patients, providers and hospital leaders in discussing appropriate use of resuscitation for COVID-19 patients.&rdquo;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
No evidence blanket &lsquo;do-not-resuscitate&rsquo; orders for COVID-19 patients are necessary. <a href="https://t.co/I5c3wJx6DA">https://t.co/I5c3wJx6DA</a>
&mdash; AmericanHeartNC (@AmericanHeartNC) <a href="https://twitter.com/AmericanHeartNC/status/1263823077588303872?ref_src=twsrc%5Etfw">May 22, 2020</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>&nbsp;

MarkAlain Déry, DO

The Significant Danger Measles Pose for Unvaccinated Children

Infectious Disease

Andrew Moreno

Antithrombotic Care in Hemophilia: A Summary of Multi-Organizational Clinical Practice Guidance

Hemophilia

James Tumlin, MD

Joel M. Topf, MD, FACP

Proteinuria Remission With Sparsentan in FSGS

NKF Spring Clinical Meetings 2025

Latest News

Blanket 'Do-Not-Resuscitate' Orders for COVID-19 Patients are Inappropriate, Study Finds

COVID-19

It's not necessary to consider blanket do-not-resuscitate orders for SARS-CoV-2 (COVID-19) patients because there's insufficient data on US survival rates and for in-hospital ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe