Enohumah K O, Moerer O, Kirmse C, Bahr J, Neumann P, Quintel M
Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August University Hospital, Robert Koch Str. 40, D-37075 Goettingen, Germany.
Resuscitation. 2006 Nov;71(2):161-70. doi: 10.1016/j.resuscitation.2006.03.013. Epub 2006 Sep 20.
The purpose of this study is to evaluate the demographic characteristics of patients who suffered cardiac arrest in our intensive care units (ICUs) as well as to identify those factors influencing outcome after resuscitation following cardiac arrest.
We reviewed the records of all patients who underwent cardiopulmonary resuscitation (CPR) in our ICUs at the Georg-August University Hospital, Goettingen, Germany, from January 1, 1999 to December 31, 2003.
One hundred and sixty-nine patients underwent CPR. Severity of illness assessed by SAPS II score on admission was 51.8+/-18.5 (predicted mortality 46.6%). The initially monitored rhythm at the time of arrest was asystole in 51 (30.2%) patients. Ventricular tachycardia/fibrillation (VT/VF) was recorded in 65 (38.5%) and pulseless electrical activity in 49 (29.0%) patients. Twenty (23.8%), 28 (33.3%) and 33 (39.3%) patients with initially recorded asystole, VT/VF and pulseless electrical activity (PEA) rhythms, respectively, survived to ICU discharge. Eighty of the 169 patients survived to hospital discharge giving a survival rate of 47.3%. The highest ICU mortality was seen in patients admitted for neurosurgery (80%) followed by major vascular surgery (77.8%), non-surgical patients (67.4%) and patients with severe sepsis (66.7%). The occurrence of cardiac arrest within the first 24h was associated with a significantly lower ICU mortality compared to a later incident. At hospital discharge 66 patients (82.5% of the survivors) achieved good cerebral recovery, 12 patients (15.0%) were severely disabled (CPC 3) while 2 (2.5%) remained unconscious.
Several factors affect the outcome from CPR. However, quicker triage to ICU, closer monitoring along with prompt intervention might minimise the consequences of cardiac arrest and its complications.
本研究的目的是评估在我们重症监护病房（ICU）发生心脏骤停的患者的人口统计学特征，并确定那些影响心脏骤停复苏后结局的因素。
我们回顾了1999年1月1日至2003年12月31日在德国哥廷根的格奥尔格 - 奥古斯特大学医院ICU接受心肺复苏（CPR）的所有患者的记录。
169例患者接受了CPR。入院时通过简化急性生理学评分系统II（SAPS II）评估的疾病严重程度为51.8±18.5（预测死亡率46.6%）。心脏骤停时最初监测到的心律，51例（30.2%）患者为心搏停止。65例（38.5%）记录到室性心动过速/心室颤动（VT/VF），49例（29.0%）患者为无脉电活动。最初记录为心搏停止、VT/VF和无脉电活动（PEA）心律的患者分别有20例（23.8%）、28例（33.3%）和33例（39.3%）存活至ICU出院。169例患者中有80例存活至出院，生存率为47.3%。入住ICU死亡率最高的是神经外科患者（80%），其次是大血管手术患者（77.8%）、非手术患者（67.4%）和严重脓毒症患者（66.7%）。与后期发生的心脏骤停相比，在最初24小时内发生心脏骤停与显著更低的ICU死亡率相关。出院时，66例患者（占幸存者的82.5%）实现了良好的脑功能恢复，12例患者（15.0%）严重残疾（脑功能分级3级），而2例（2.5%）仍昏迷。
几个因素影响CPR的结局。然而，更快地分诊至ICU、更密切的监测以及及时的干预可能会将心脏骤停及其并发症的后果降至最低。
