Little Charles M, Paradis Norman A, Heard Kennon
Division of Emergency Medicine, Department of Surgery, University of Colorado School of Medicine, Colorado Emergency Medicine Research Center, Denver, Colorado, USA.
Semin Neurol. 2006 Sep;26(4):380-6. doi: 10.1055/s-2006-948318.
As many cases of cardiac arrest occur outside of the health care setting, prehospital treatment may dramatically affect patient outcomes. The three major interventions that have been studied are chest compressions and ventilation, electrical defibrillation, and medications. Recent studies show that increasing the rate of cardiopulmonary resuscitation (CPR), decreasing the rate of ventilation, and initiation of CPR prior to defibrillation may result in improved survival. Biphasic defibrillators can restore perfusing rhythms while minimizing myocardial injury. Public access to automatic defibrillators has been shown to increase the survival of cardiac arrest patients. Medications such as amiodarone, vasopressin, and thrombolytics also may have a role in the prehospital treatment of cardiac arrest. Recent advances in these areas will be reviewed with a discussion of the effect of each intervention on the restoration of circulation and neurological outcomes.
由于许多心脏骤停病例发生在医疗保健机构之外，院前治疗可能会显著影响患者的预后。已研究的三大干预措施为胸外按压与通气、电除颤和药物治疗。最近的研究表明，提高心肺复苏（CPR）的速率、降低通气速率以及在除颤之前开始进行CPR可能会提高生存率。双相除颤器能够恢复灌注节律，同时将心肌损伤降至最低。事实证明，公众可使用自动体外除颤器可提高心脏骤停患者的生存率。诸如胺碘酮、血管加压素和溶栓药物等在心脏骤停的院前治疗中也可能发挥作用。将对这些领域的最新进展进行综述，并讨论每种干预措施对循环恢复和神经学转归的影响。
