Peberdy Mary Ann, Kaye William, Ornato Joseph P, Larkin Gregory L, Nadkarni Vinay, Mancini Mary Elizabeth, Berg Robert A, Nichol Graham, Lane-Trultt Tanya
Virginia Commonwealth University's Health System, West Hospital, Richmond, VA 23298, USA.
Resuscitation. 2003 Sep;58(3):297-308. doi: 10.1016/s0300-9572(03)00215-6.
The National Registry of Cardiopulmonary Resuscitation (NRCPR) is an American Heart Association (AHA)-sponsored, prospective, multisite, observational study of in-hospital resuscitation. The NRCPR is currently the largest registry of its kind. The purpose of this article is to describe the NRCPR and to provide the first comprehensive, Utstein-based, standardized characterization of in-hospital resuscitation in the United States. All adult (>/=18 years of age) and pediatric (<18 years of age) patients, visitors, employees, and staff within a facility (including ambulatory care areas) who experience a resuscitation event are eligible for inclusion in the NRCPR database. Between January 1, 2000, and June 30, 2002, 14720 cardiac arrests that met inclusion criteria occurred in adults at the 207 participating hospitals. An organized emergency team is available 24 h a day, 7 days a week in 86% of participating institutions. The three most common reasons for cardiac arrest in adults were (1) cardiac arrhythmia, (2) acute respiratory insufficiency, and (3) hypotension. Overall, 44% of adult in-hospital cardiac arrest victims had a return of spontaneous circulation (ROSC); 17% survived to hospital discharge. Despite the fact that a primary arrhythmia was one of the precipitating events in nearly one half of adult cardiac arrests, ventricular fibrillation (VF) was the initial pulseless rhythm in only 16% of in-hospital cardiac arrest victims. ROSC occurred in 58% of VF cases, yielding a survival-to-hospital discharge rate of 34% in this subset of patients. An automated external defibrillator was used to provide initial defibrillation in only 1.4% of patients whose initial cardiac arrest rhythm was VF. Neurological outcome in discharged survivors was generally good. Eighty-six percent of patients with Cerebral Performance Category-1 (CPC-1) at the time of hospital admission had a postarrest CPC-1 at the time of hospital discharge.
美国国家心肺复苏注册系统（NRCPR）是一项由美国心脏协会（AHA）发起的、前瞻性、多中心的院内复苏观察性研究。NRCPR是目前同类最大的注册系统。本文旨在描述NRCPR，并首次提供基于乌斯坦模式的、关于美国院内复苏的全面标准化特征。在一个机构（包括门诊护理区域）内经历复苏事件的所有成年（≥18岁）和儿科（<18岁）患者、访客、员工和工作人员均有资格纳入NRCPR数据库。在2000年1月1日至2002年6月30日期间，207家参与研究的医院中有14720例符合纳入标准的成年人心脏骤停事件发生。86%的参与机构每周7天、每天24小时都有一支有组织的急救团队。成年人心脏骤停最常见的三个原因是：（1）心律失常，（2）急性呼吸功能不全，（3）低血压。总体而言，44%的成年院内心脏骤停患者恢复了自主循环（ROSC）；17%存活至出院。尽管原发性心律失常是近一半成年心脏骤停的诱发事件之一，但心室颤动（VF）仅在16%的院内心脏骤停患者中是初始无脉心律。ROSC发生在58%的VF病例中，在这一亚组患者中出院存活率为34%。仅1.4%初始心脏骤停心律为VF的患者使用了自动体外除颤器进行初始除颤。出院存活者的神经学转归总体良好。入院时脑功能分级为1级（CPC-1）的患者中，86%在出院时心脏骤停后CPC仍为1级。
