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(p = 0.009). Survival was better (p = 0.027) if the initial rhythm was shockable during CPR,if the patient was male or under 60 yrs (p = 0.04, or p = 0.062 respectively). The inten-sive care dependency was higher in OHCA group (p = 0.016), the non-intensive post CPRtreatment need was higher in IHCA group (p = 0.004). The need of catecholamines (p

doi:10.1016/j.resuscitation.2010.09.171

40 Abstracts / Resuscita

P023

udden cardiac death and sport in Luxembourg: Incitement for a public health strat-gy

ax A. 1, Clarens C. 2, Delagardelle Ch. 3, Urhausen A. 4

Department of Sports Medecine, Ministry of Sports, Luxembourg, GDLEmergency Medical Service, Fire-Brigade, Luxembourg, GDLDepartment of Cardiology, Hospital Center, Luxembourg, GDLDepartment of Sports Medecine, Hospital Center, Luxembourg, GDL

Purpose of study: Unexplained premature Sudden Cardiac Death (SCD) of youngportsmen – at athletes, college, amateur league or professional level has become aighly public health concern. Extensive media coverage stimulates discussions also inuxembourg about primary prevention strategies.

Materials and methods: Collecting Data from experts in sport medicine, case reportsf Emergency Medical Services and medical literature raised our interest to analyze SCD.omprehension of personal and family history, pre-participation targeted exam includingrest-12 lead Electrocardiogram (ECG) are valuable tools. In certain cases, an accurate ECG

nterpretation followed by electrophysiologic exam and specific genetic screenings helpo identify athletes with potentially lethal cardiovascular risk.1

Results: Worldwide SCD occurs in 6000 athletes/year.2 Following causes haveeen identified: abnormal coronary arteries, hypertrophic obstructive cardiomyopa-hy, myocarditis, abnormal conductive and cardiac arrhythmic problems such as

olff–Parkinson–White, long QT, Brugada syndromes and dysplasia of right ventricle. In0–12% of cases, SCD occurs in apparently healthy hearts and is due to catecholaminergicolymorphic ventricular tachycardia or to “Torsades de Pointe”.3

24.62% of Luxembourg population is practicing in 55 different sport federations.xperts estimate SCD incidence rate between 2 and 8 young sportsmen/year.4

The compulsory national pre-participation medical exam for every licensed sportarticipant – a highly effective measure for SCD prevention including a rest ECG – enableso select high risk athletes. Legislation allows non-medical lay people to use Automaticxternal Defibrillators (AED), a measure among others to fight against SCD. Systematicardiac arrest registry helps to foster the problem.

Conclusion: Primary preventive public health strategies, improvement of emergencyesponse and the use of AED in the athletic settings should be implemented. Basic Lifeupport (BLS) and AED training for emergency technicians, coaches and on-site publicust be considered.5

eferences

1. Corrado D, Pelliccia A, Bjørnstad HH, et al. Cardiovascular pre-participation screeningof young competitive athletes for prevention of sudden death: proposal for a commonEuropean protocol. Consensus statement of the Study Group of Sports Cardiology ofthe Working Group of Cardiac Rehabilitation and Exercise Physiology and the WorkingGroup of Myocardial and Pericardial diseases of the European Society of Cardiology.Eur Heart J 2005;26:516–24.

2. Meijbaum E, Chair Maron B. “Sudden Death in the Young Athlete” Jacc Chicago 2008;31. 03. 2008: IOC Lausanne.

3. Napolitano C, Priori SG, Bloise R. “Catecholaminergic Polymorphic Ventricular Tachy-cardia” University of Washington, Seattle 1993; 2004;October 14 (updated 2009; July07).

4. Chevalier L, Hajjar M, Douard H, Cherief A. Sports-related acute cardiovascular eventsin a general population: a French prospective study. The European Society of Cardiol-ogy 2009. Eur J Cardiovasc Prevent Rehabil 2009;16:365–70.

5. Rao AL, Standaert CJ, Drezner JA, Herring SA. Expert opinion and controversies inmusculoskeletal and sports medicine: preventing sudden cardiac death in young ath-letes. Arch Phys Med Rehabil 2010;91:958–62. American Congress of RehabilitationMedicine, Elsevier.

oi:10.1016/j.resuscitation.2010.09.168

P024

astroesophageal laceration after cardiopulmonary resuscitation

ita Moreira, Carvalho Antonio, Goncalves Iran, Furtado Fabricio, Vellozo Ana, Caluzaernando, Colleone Ramiro, Santos Vinicius

Cardiology, Hospital São Paulo, Federal University of São Paulo, Brazil

Although gastric laceration is said to occur on 9-12% of patients receiving cardiopul-onary resuscitation (CPR), and we found only five reports in international literature that

eported such an event, when you used keywords: gastric laceration; cardiac arrest andardiopulmonary resuscitation

Case report: A 75-year-old man, had a cardiac arrest in a hotel, in Ventricular Fib-illation and ventilation and chest compression were performed for 10 min and he wasransported to an ER, CPR maneuvers and secondary care were done in accordance withhe guidelines of the American Heart Association during 30 min.

After the spontaneous circulation the patient returned to sinus rhythm with ST-

egment elevation in the inferior, lateral and dorsal ECG leads, intubated on mechanicalentilation and stable at the vasopressor support to maintain blood pressure was referredo the cath lab.

During the coronary angiography the patient developed upper gastric bleeding, con-rmed after placement of the nasogastric tube, with fall of erythrocyte level (initial Hb:5.2, control Hb 10.0). The procedure was discontinued and the patient was underwent aastric endoscopy revealed that ulcers in the stomach region of the notch and laceration

1S (2010) S1–S114

cardia with active bleeding signs; after embolization therapy; he stayed at Intensive CareUnit which after 106 days progressed to death from multiple organs failure.

Discussion: There is a paucity of information on this area in the last 30 years; it isimportant to note that the complication evidenced by endoscopy can probably be relatedto a failure of chest compression or excessive gastric distension to a secondary ventilationproblem induced by bag-valve-mask.

Conclusion: Attention to the technique of chest compression and ventilation and con-tinuous training is probably the correct way to minimize the incidence of complicationsafter cardiopulmonary resuscitation that increases the risk of death in these patients.

doi:10.1016/j.resuscitation.2010.09.169

AP025

Characteristics of patients who survive to hospital admission despite unsuccessfulpre-hospital resuscitation

Innes J. 1, Donohoe R.T. 1, Liu P.Y. 2, Jorgenson D.B. 2, Nammi K. 2, Matallana L. 3, Whit-bread M. 4, Kaufman B.J. 3, Prezant D.J. 3, Silverman R.A. 3, Freese J.P. 3

1 London Ambulance Service NHS Trust, London, UK2 Philips, Seattle, USA3 New York City Fire Department, New York, USA4 London Ambulance Service NHS Trust, London, UK

Purpose: Out-of-hospital cardiac arrest patients who do not respond to resuscitationefforts in the field rarely survive to hospital admission or discharge. In fact, termination ofresuscitation rules suggest these patients should not be transported to hospital. We soughtto determine the characteristics of the small group who survive to hospital admissiondespite unsuccessful pre-hospital resuscitation.

Methods: Data collected from 985 ventricular fibrillation (VF) pre-hospital cardiacarrests of cardiac aetiology, as part of a large multi-site randomised controlled trial, wereanalysed. Comparisons were made between those successfully resuscitated in the field(achieved return of spontaneous circulation (ROSC)) and those not.

Results: ROSC was achieved in the field by 412/985 patients (41.8%). Of these, 411(99.8%) were transported to hospital, 317 (76.9%) were admitted and 157 (38.1%) survivedto hospital discharge. Among the 573 patients who did not achieve ROSC, 518 (90.4%)were transported to hospital, 32 (5.6%) were admitted and 5 (0.9%) survived to hospi-tal discharge. No significant differences were noted for age, ethnicity, or other arrestcharacteristics, despite a trend toward female gender among those surviving to hospi-tal admission despite not achieving ROSC when compared to those who did (44% vs. 29%,p = .11). The median length of stay for those who were admitted to hospital despite unsuc-cessful pre-hospital resuscitation was 3.0 days (1.5 days for those who did not survive).For those that were admitted to hospital after achieving ROSC in the field, the medianlength of stay was 8 days (2.0 days for those who did not survive).

Conclusions: Despite unsuccessful resuscitation in the field, patients presenting withVF may survive to hospital discharge suggesting these patients should always be trans-ported to hospital. Our data indicates that only a small burden would be placed onreceiving hospitals in order to maximise the potential survival of such patients.

doi:10.1016/j.resuscitation.2010.09.170

AP026

Retrospective analysis of survival data of in-hospital and out-of-hospital resuscitatedpatients in the practice of Semmelweis University Heart Centre

Zima E., Jenei Z., Kovacs E., Barany T., Osztheimer I., Nardai S., Geller L., Merkely B.

Coronary Intensive Care Unit, Semmelweis University Heart Centre, Hungary

Circumstances and methods of cardiopulmonary resuscitation (CPR) determine theneurologic and survival outcome. Our aim was to analyse retrospectively the data ofresuscitated patients treated in Semmelweis University Heart Centre. A comparison wasdone between the in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) patientgroups, mortality data and survival determining intensive therapeutic factors were ana-lyzed. Statistics were done by Kaplan Meier log rank test, Khi2 and t-tests. Out of the 6693patients treated in our centre 48 (34 male and 14 female) got over successful CPR. n = 31OHCA and n = 17 IHCA indicated CPR. No difference was found in survival between IHCAand OHCA groups, though short term neurological outcome was better in IHCA group