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Todo el esfuerzo y dedicación: A mi familia: a mi amor kely, a mi madre Rosario, a mi abuela
Hilda, a mis hermanos y sobrinas, quienes serán siempre mi estímulo de superación personal.

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3  4
A los amigos sinceros: humberto, julio, salvador, josé enrique por sus buenos consejos y el
apoyo personal.
A los maestros, asesores y compañeros que me brindaros su amistad, sus enseñanzas y
oportunos consejos durante el tiempo de preparación en el hospital edgardo rebagliati martins.
A los colegas de la especialidad con quienes compartí una incomparable amistad: martín,
luis alberto, carlos y milton.
A Dr Wilfredo galvez por sus consejos y orientación en mi trabajo de investigación.

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Se evaluaron de manera retrospectiva a 80 casos de pacientes que presentaron paro
cardio-respiratorio en la Unidad de Shock Trauma y Unidad de Cuidados Críticos del
Departamento de Emergencia del Hospital Nacional Edgardo Rebagliatti EsSalud, de 01/03/2002
al 28/03/2003. Las variables establecidas en el estudio incluyeron edad, sexo, antecedentes
patológicos, evolución neurológico, patrón electrocardiográfico y supervivencia hospitalaria.
Se encontró que los pacientes seniles con antecedentes patológicos asociados representan un
bajo nivel de supervivencia post reanimación cardiopulmonar no obstante el tratamiento con los
avances tecnológicos modernos.
Palabras Claves: resucitación cardiopulmonar, supervivencia, pronóstico.

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They were evaluated from a retrospective way to 80 cases of patients that presented
cardiopulmonary arrest unemployment witnessed in the Unit of Shock Trauma and Unit of
Critical Cares of Emergency of the National Hospital Edgardo Rebagliatti EsSalud, from
01/03/2002 to 28/03/2003, with favorable initial answer. Inside the variables in the study: age,
sex, pathological antecedent, neurological evolution, electrocardiography pattern and hospital
survival they were included.
Finding that the senile patients with clinical antecedents pathology have a low-level of
survival post cardiopulmonary reanimation, nevertheless the treatment with the modern
technological advances.
Key words: Cardiopulmonary Resuscitation, survival, predictor.

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VIGO J. “Reanimación Cardiopulmonar: aspectos generales”. Revista Ciencia y

Tecnología. Jul 1997. Vol 6 N°1.pp33-7
SHOEMAKER, Ayres, et al. “Reanimación” de Tratado de Medicina Crítica y terapia
intensiva. 3° edición. Editorial Panamericana. 1996.pp:16-28.
MARK G. Goetting “Reanimación Cardiopulmonar” de Clínicas Pediátricas de Cuidados
Intensivos. Editorial Panamericana.1994. Vol 6. 1143-77.
BERTRAND RUSSELL“Paro Cardiaco”. En: Paul L. Marino, M.D. Libros de la UCI. 2°
Edición. Williams & Wilkins.España. 1998. pp 279-297.
MONSERRAT Rué, et al. “Mortalidad y estancia hospitalaria ajustadas por gravedad
como indicadores de efectividad y eficiencia de la atención de pacientes en estado
crítico”. Medicina Clínica.1997. 108, (17): 647-51.
Oficina de Estadística e Informática del Hospital “Edgardo Rebagliatti Martins” EsSalud
Lima. Perú.
FONTANALS J, Miro O, Pastor X, et al. “Reanimación Cardiopulmonar en pacientes
hospitalizados en unidades convencionales”. Comisión de atención al paro
cardiorrespiratorio. Med Clínica. Mar. 1997. 108; (12): 441-5
SCHEIN RMB, Hazday N, Peña M, Ruben BH, Sprung CL, “ClinicalAntecedents to
Hospital Cardiopulmonary Arrest”. Chest 1990:98. 388-92.
LOMBARDI G, Gallagher Ej, Gennis p. “Qutcome of out Hospital Cardiac Arrest in New

-./ 01232 4 5
672 28  - :;
  !" #$ %& ' %#$ (&  #&% ) $*$ $( 
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York City The Pre-hospital Arrest Survival Evaluation (PHASE) Study”. JAMA March
2; 1994: 9: 678-83
GARCIA – GUASCH Camet J. “Reanimación Cardiopulmonar en pacientes ingresados
en unidades de hospitalización convencional”. Med Clin. 1997. 108; (12): 455-57.
HERSHEY CO. Fisher I “Why outcome of Cardiopulmonar y Resuscitation in General
wards is poor The Lancet: Jan 1982: 31-4
BONNIN MJ, Pepe PE, KT, Clark PS. “Distinet Criteria for Termination of Resuscitation
in the Out –of- Hospital Setting” JAMA 1993 Spt 22/29; 270: 12.
EARNEST MP, Breckinridge Jc, Yarnell PR, Oliva PB “Quality of survival after
out-of-hospital cardiac arrest: Predictive value of early neurologic evaluation”
NEUROLOGY 1979. Jan: 29: 56-60.
TAFFET GE, Teasdale TA, Luchi RJ. “In Hospital Cardiopulmonary Resuscitation”.
JAMA, Oct 14; 260: 14
BALLEW KA: Philbrick JT. Caven DE, Scholing JB. “Predictors of Survival Following
In-Hospital Cardiopulmonary Resuscitation” 1994; 154: 2426-37
THOMAS H. Et al. “Response Time Effectiveness”. Comparison of Response Time and
Survival in an Urban Emergency Medical Services System. Academic Emergency
Medicine. 9: (4) : 288-295. 2002
TUNSTALL_PEDOE H. Bailey L. Chamberlain DA. Marsden Ak. Ward ME, Zideman
DA. “Survey of 3765 cardiopulmonary resuscitations in British hospitals (The
BRESUS study): methods and overall results”. BMJ 1992 (May). 304: 1347-51.
GRAY WA, Capone RJ, Most AS. “Unsuccesstul Emergency Medical Resuscitation-are
continued effors in the Emergency Deparment justified?. The new England Journal of
Medicine. Nov 4. 1991, 325:20.
BEDELL SA, Delbanco TL, Cook EF, Epstein F. “Survival after Cardiopulmonary
Resuscitation in he Hospital” Sep 8 1983; 309: 10
JOHNSON AL, Tanser PH, Ulan RA, Wood “Results of Cardiac Resuscitation in 552
Patients”. Montreal – Canadá. The American Journal of Cardiology 1987; 20:831-5
GEORGE AL, Folk BP, Crecelius PL, Campbell WB. “Pre-Arrest Morbidity and Other
Correlates of Survival after in-Hospital Cardiopulmonary Arrest”. The American
Journal of Medicine July 1989; 87: 28 – 34.
GLINER, BE; WHITE, RD. “Electrocardiographic evaluation of fibrilation shock delivered
to out-of-hospital suden cardiac arrest patients”. Resuscitation. 41:(2) 133-144 July
1999.
HEIKKI V, Huikuri, Agustín Castellanos, Robert J; Myerburg. “Suden Death Due to
Cardiac Arrhythmias”. The New England Journal Of Medicine. Vol 345: N° 20:
1473-1482. Nov 15, 2001.
EBMEYER, E. Abramson N, Katz L. “Current research directions in cerebral
resuscitation afler cardiac arrest” de Current Opinión in Critical Care. Vol. 1 N° 3 Jun
1995; 1: 1: 182-88.
REDMOND, WA, “Study Report Highest Document Cardiac Arrest Survival Rate”. De
American Medical Association Navigation. Internet, May 15 1998.

:< -./ 01232 4 5

672 28  -
 773 8

SCHNEIDER MS, Eisenberg MS, Hallstrom A, Bergner L. “Long-term survival after

out-of Hospital Cardiac Arrest”. The New England Journal Of Medicine. Jun 3, 1982;
1340-3.
Soporte Cardiaco Avanzado de Vida A. C. L. S. Nuevas Guías del año 2000.
ROINE. RO; Kaste M. Kinnunen A. Nikki P; Sarna S; Kajaste S. “Nimodipine after
Resuscitation From Out–of–Hospital Ventricular Fibrillation. A placebo–controlled.
Double–blind. Randomized trial”. JAMA Dec 26. 1990; 264: 24. 3171-79.
LEVY DE, Caronna JJ, Singer BH, Lapinsky RH, Frydman H, Plum F.” Predicting
Outcome From Hypoxic-Ischemic Coma” JAMA. March 8 1985; 253: 10.
LONGSTRETH WT, Diehr P. Inui T. “Prediction of awakening afler out-of-Hospital
Cardiac Arrest.” The new En gland journal medicine. Jun 1983; 482.
MURPHY DJ, Burrows D, Santilli S, Kemp AW, Tenner S, Kreling B, et al.” The
influence of the probability of Survival on patients preferences regarding
Cardiopulmonary Resuscitation “The New England Journal of Medicine. Feb 24.
1994: 330:8
SÉLLER RF. Steele PL, Fiher JD. Alexander HM. Dobson A. “ Succes of
cardiopulmonary resuscitation after Heart attaks in hospital and outside hospital”:
British medical Journal BMJ. Nov 18 1995;311:1332-39.
LARSEN, MP; Eisemberg MS, et al. “Predicting survival from out-of-hospital cardiac
arrest- a graphic model”. Annals Of Emergency Medicine. Nov 1993. 22: (11) :
1652-58.
THOMAS, D. Rea; et al . “Dispatcher- Assisted Cardiopulmonary Resuscitation and
Survival in cardiac Arrest”. Circulation. 2001. Vol 104. N° 21. 2313.
FALK, J; Theodorson D. “Monitoring the efectiveness of cardiopulmonary resuscitation”
de Current Opinión in Critical Care. Jun 1995. 01, (3) :159-65.
ROMANO, P; Calif S. “Do not resucitate orders: is there really disparity by diagnosis?”
de Arch. Internal Medicine. De american association navigation. Internet. Nov 25.
1998.
GONZALES, E; Grillo J. “Pathophysiology considerations in the selection of drug
therapy to augment flow and prevent reperfusion injury during cardiac arrest”. De
Current opinión in Critical Care. Vol 1 N° 3. Jun 1995, 1 (3): 166-71.

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