Timerman A, Sauaia N, Piegas L S, Ramos R F, Gun C, Santos E S, Bianco A C, Sousa J E
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Arq Bras Cardiol. 2001 Aug;77(2):142-60. doi: 10.1590/s0066-782x2001000800006.
To analyze the early and late results of cardiopulmonary resuscitation in a cardiology hospital and to try to detect prognostic determinants of both short- and long-term survival.
A series of 557 patients who suffered cardiorespiratory arrest (CRA) at the Dante Pazzanese Cardiology Institute over a period of 5 years was analyzed to examine factors predicting successful resuscitation and long-term survival.
Ressuscitation maneuvers were tried in 536 patients; 281 patients (52.4%) died immediately, and 164 patients (30.6%) survived for than 24 hours. The 87 patients who survived for more than 1 month after CRA were compared with nonsurvivors. Coronary disease, cardiomyopathy, and valvular disease had a better prognosis. Primary arrhythmia occurred in 73.5% of the >1-month survivor group and heart failure occurred in 12.6% of this group. In those patients in whom the initial mechanism of CRA was ventricular fibrillation, 33.3% survived for more than 1 month, but of those with ventricular asystole only 4.3% survived. None of the 10 patients with electromechanical dissociation survived. There was worse prognosis in patients included in the extreme age groups (zero to 10 years and 70 years or more). The best results occurred when the cardiac arrest took place in the catheterization laboratories. The worst results occurred in the intensive care unit and the hemodialysis room.
The results in our series may serve as a helpful guide to physicians with the difficult task of deciding when not to resuscitate or when to stop resuscitation efforts.
分析一家心脏病医院心肺复苏的早期和晚期结果，并试图找出短期和长期生存的预后决定因素。
对在但丁·帕扎内塞心脏病研究所5年期间发生心肺骤停（CRA）的557例患者进行了系列分析，以研究预测复苏成功和长期生存的因素。
对536例患者进行了复苏操作；281例患者（52.4%）立即死亡，164例患者（30.6%）存活超过24小时。将CRA后存活超过1个月的87例患者与未存活者进行比较。冠心病、心肌病和瓣膜病的预后较好。初始CRA机制为室颤的患者中，33.3%存活超过1个月，但初始机制为心室停搏的患者中只有4.3%存活。10例电机械分离患者无一存活。极端年龄组（0至10岁和70岁及以上）的患者预后较差。心脏骤停发生在导管室时结果最佳。重症监护病房和血液透析室的结果最差。
我们系列研究的结果可为医生在决定何时不进行复苏或何时停止复苏努力这项艰巨任务时提供有用的指导。
