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Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment
Authors:Patricia Jabre  Karim Tazarourte  Elie Azoulay  Stephen W Borron  Vanessa Belpomme  Line Jacob  Lionel Bertrand  Frederic Lapostolle  Xavier Combes  Michel Galinski  Virginie Pinaud  Carla Destefano  Domitille Normand  Alexandra Beltramini  Nathalie Assez  Benoit Vivien  Eric Vicaut  Frederic Adnet
Institution:1. AP-HP, Urgences-Samu 93, H?pital Avicenne, Université Paris 13, 93000, Bobigny, France
2. Inserm U970, Centre de Recherche Cardiovasculaire de Paris, Université Paris Descartes, Paris, France
3. AP-HP, Samu de Paris, H?pital Necker-Enfants Malades, Paris, France
4. Samu 77, CH Melun, 77000, Melun, France
5. AP-HP, Réanimation médicale, H?pital Saint-Louis, Paris, France
6. Department of Emergency Medicine, Texas Tech University HSC, El Paso, TX, USA
7. AP-HP, Smur Beaujon, H?pital Beaujon, Clichy, France
8. AP-HP, Samu 94, H?pital Henri Mondor, 94000, Créteil, France
9. Samu 82, H?pital de Montauban, Montauban, France
10. Samu de La Réunion, CHU de Saint-Denis, La Réunion, France
11. Samu 44, CHU de Nantes, 44093, Nantes Cedex, France
12. Samu 28, H?pital de Dreux, 28100, Dreux, France
13. Samu 59, CHRU de Lille, 59000, Lille, France
14. AP-HP, Unité de Recherche Clinique, H?pital Fernand Widal, Paris, France
Abstract:

Purpose

To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option.

Methods

Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief.

Results

Among the 570 family members intention to treat (ITT) population], 408 (72 %) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group adjusted odds ratio, 1.8; 95 % confidence interval (CI) 1.1–3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR adjusted odds ratio, 1.7; 95 % CI 1.1–2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23 %; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24 %; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21 %; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23 %; P = 0.003).

Conclusions

At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.
Keywords:
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