The Australasian ANZSCTS/ANZICS guidelines on cardiothoracic advanced life support (CALS-ANZ)

Abstract

Every year, more than 15 000 patients undergo cardiac surgery in Australia and NewZealand. 1 The overall incidence of cardiac arrest after cardiac surgery is between 0.7% and5.2%. 2, 3, 4, 5, 6 Most cardiac arrests occur within 24 hours of surgery, with up to 50% occurring in the first 3 hours following intensive care unit (ICU)admission. 2, 7 Compared with other in-hospital cardiac arrests, survival in this patient population is high (75% v 39%). 2, 8 The reasons for this include the high degree of cardiac monitoring; a high proportion of reversible causes, such as pericardial tamponade or haemorrhage, and the effects of internal cardiacmassage. 9, 10, 11 The application of standard advanced life support protocols in post-surgical cardiothoracic patients may lead to avoidable adverse events, and hence, specific resuscitation protocols have been developed and established in Europe and NorthAmerica. 12