Resuscitation after cardiac surgery awareness: an Egyptian national survey

Abstract
Background
Cardiac surgery patients have different resuscitative needs than other patients who experience in-hospital cardiac arrest; this was addressed in the guidelines. However, it is unknown how widely the guidelines are practiced, or a training protocol is followed in different cardiac surgery units in Egypt.

Methods
A 21-question survey was created and included: Participant demographics, prevalence of cardiac arrest, cardiac arrest protocol, emergency resternotomy technique, training protocols. Survey was disseminated through social media messaging platforms during the period between November 2020 and January 2021.

Results
Ninety-five responses were from 11 centres across Egypt. In total, 68.5% of the respondents were surgeons, 76.8% of participants were junior surgeons. For patients who go into VF after cardiac surgery, respondents would attempt a median of 3 shocks with only 24.2% commencing defibrillation shocks before external cardiac massage, whilst the majority initiating CPR immediately and performing emergency resternotomy in a median time of 10 min. In total, 56.8% would give 1 mg of adrenaline as soon as the cardiac arrest was established. If a surgeon was not available, only 36.8% of respondents would allow any trained personnel to perform the emergency resternotomy. Only 9.5% practice regularly on emergency sternotomies. Seventy-five percent think tailored training is important and staff should be oriented about it in the future.

Conclusion
An action plan is required to improve the training of the junior surgeons regarding the Cardiac Advanced Life Support Protocol to implement it in a timely organised manner. This should be endorsed and audited by a national society or body by keeping a national registry and mandatory recertification.