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Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment

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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.

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Acknowledgments

Supported by the Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health and by the Research Delegation of the Assistance Publique – Hopitaux de Paris (Aurélie Guimfack and Christine Lanau). We are indebted to Martine Tanke, who monitored the ongoing results of the trial; to the physicians, nurses, and ambulance attendants of each center for their valuable cooperation with the study; to Malika Chafai for her secretarial assistance. This study was funded solely by the Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health.

Conflicts of interest

No author has a conflict of interest with regard to this study.

Author information

Authors and Affiliations

  1. AP-HP, Urgences-Samu 93, Hôpital Avicenne, Université Paris 13, 93000, Bobigny, France

    Patricia Jabre, Frederic Lapostolle, Michel Galinski, Carla Destefano, Domitille Normand & Frederic Adnet

  2. Inserm U970, Centre de Recherche Cardiovasculaire de Paris, Université Paris Descartes, Paris, France

    Patricia Jabre

  3. AP-HP, Samu de Paris, Hôpital Necker-Enfants Malades, Paris, France

    Patricia Jabre & Benoit Vivien

  4. Samu 77, CH Melun, 77000, Melun, France

    Karim Tazarourte

  5. AP-HP, Réanimation médicale, Hôpital Saint-Louis, Paris, France

    Elie Azoulay

  6. Department of Emergency Medicine, Texas Tech University HSC, El Paso, TX, USA

    Stephen W. Borron

  7. AP-HP, Smur Beaujon, Hôpital Beaujon, Clichy, France

    Vanessa Belpomme

  8. AP-HP, Samu 94, Hôpital Henri Mondor, 94000, Créteil, France

    Line Jacob

  9. Samu 82, Hôpital de Montauban, Montauban, France

    Lionel Bertrand

  10. Samu de La Réunion, CHU de Saint-Denis, La Réunion, France

    Xavier Combes

  11. Samu 44, CHU de Nantes, 44093, Nantes Cedex, France

    Virginie Pinaud

  12. Samu 28, Hôpital de Dreux, 28100, Dreux, France

    Alexandra Beltramini

  13. Samu 59, CHRU de Lille, 59000, Lille, France

    Nathalie Assez

  14. AP-HP, Unité de Recherche Clinique, Hôpital Fernand Widal, Paris, France

    Eric Vicaut

Authors
  1. Patricia Jabre
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  2. Karim Tazarourte
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  3. Elie Azoulay
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  9. Xavier Combes
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  10. Michel Galinski
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  11. Virginie Pinaud
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  13. Domitille Normand
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  14. Alexandra Beltramini
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  15. Nathalie Assez
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  16. Benoit Vivien
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  17. Eric Vicaut
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  18. Frederic Adnet
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Corresponding author

Correspondence to Frederic Adnet.

Additional information

Take-home message: The long-term benefits on post-traumatic stress disorder and depression to being offered the possibility of witnessing resuscitation are still present at 1 year. The incidence of traumatic grief is diminished when a family member is offered the possibility of witnessing CPR.

Trial registration: ClinicalTrials.gov number, NCT01009606.

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Jabre, P., Tazarourte, K., Azoulay, E. et al. Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment. Intensive Care Med 40, 981–987 (2014). https://doi.org/10.1007/s00134-014-3337-1

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  • DOI: https://doi.org/10.1007/s00134-014-3337-1

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