Ramírez Rivera J, Velázquez I, Jaume Anselmi F
Department of Medicine, University of Puerto Rico, School of Medicine, La Concepción Hospital, San Germán.
Bol Asoc Med P R. 1992 Apr-May;84(4-5):139-43.
Nine hundred and twenty-two attending physicians, residents and graduate nurses in five hospitals were requested to state their personal preference to receive either cardiopulmonary resuscitation (CPR) or intubation and mechanical ventilation (MV) when given three estimated outcomes: 1) complete recovery, 2) important loss in mental and physical functions, c) persistent unconsciousness. They also could choose not to accept either procedure. Seventy three percent would accept CPR and 70 percent MV, only if complete recovery was likely. Thirteen percent would accept CPR and MV if important losses of function were likely. Eight percent would accept CPR and 5 percent would accept MV if recovery of consciousness was unlikely. Six percent would not accept CPR and eleven percent would not accept MV under any circumstance. Men and women differed in the choice of outcomes which made resuscitation acceptable to them (p < .001). More women than men would accept CPR and MV if complete recovery was likely and were unwilling to accept CPR or MV under any circumstance at all. Half as many women as men would accept MV if they were likely to remain unconscious. Choices also varied with age and professional training. There are large individual differences as to how physicians and nurses would like their personal cardiopulmonary arrest to be managed. Their choice is appropriately influenced by the expected outcome and seems to be influenced by the local hospital setting.
研究人员要求五家医院的922名主治医生、住院医生和毕业护士,在面对三种预估结果时,表明他们个人更倾向于接受心肺复苏(CPR)还是插管及机械通气(MV):1)完全康复;2)身心功能严重受损;3)持续昏迷。他们也可以选择不接受任何一种治疗手段。只有在完全康复可能性较大时,73%的人会接受心肺复苏,70%的人会接受插管及机械通气。如果功能很可能严重受损,13%的人会接受心肺复苏和插管及机械通气。如果恢复意识可能性不大,8%的人会接受心肺复苏,5%的人会接受插管及机械通气。6%的人在任何情况下都不接受心肺复苏,11%的人在任何情况下都不接受插管及机械通气。男性和女性在使他们接受复苏的结果选择上存在差异(p < .001)。如果完全康复可能性较大,接受心肺复苏和插管及机械通气的女性比男性更多,并且在任何情况下都不愿意接受心肺复苏或插管及机械通气。如果可能一直昏迷,接受插管及机械通气的女性人数只有男性的一半。选择也因年龄和专业培训而异。医生和护士希望如何处理他们个人的心脏骤停存在很大的个体差异。他们的选择受到预期结果的适当影响,并且似乎受到当地医院环境的影响。