Gratrix Andrew P, Pittard Alison J, Bodenham Andrew R
Leeds General Infirmary, Leeds, UK.
Anaesthesia. 2007 May;62(5):434-7. doi: 10.1111/j.1365-2044.2007.04981.x.
We have reviewed retrospective data from two large UK teaching hospitals regarding outcome following out-of-hospital cardiac arrest and the suitability of non-survivors for non-heart-beating organ donation. Patients were selected retrospectively from consecutive admissions from two intensive care units who had presented following out-of-hospital cardiac arrest, to a total of 50 patients in each centre. They had all been resuscitated to achieve a spontaneous cardiac output at the scene, in transit or after arrival in hospital, and required further intensive care support due to cardiovascular, respiratory, or neurological impairment. Eighty-six patients (86%) died in the Intensive Care Unit and only 14 (14%) survived to discharge from the Unit. A further nine (9%) patients died in hospital before discharge home. Four patients (4%) were alive after 6 months and three (3%) were alive after 1 year. Fifty-seven (57%) of patients had active withdrawal of treatment with only four (4%) being potentially suitable for organ procurement having not been excluded because of age, medical history or the length of time to die following withdrawal of treatment. Our results show that only a small increase in donor organs could be potentially achieved from this population. Further work is required to determine whether such patients should be considered as non-heart-beating donors.
我们回顾了来自英国两家大型教学医院的回顾性数据，内容涉及院外心脏骤停后的结局以及非存活者作为非心脏跳动器官捐献者的适宜性。患者是从两个重症监护病房的连续入院病例中回顾性选取的，每个中心共有50例患者。这些患者均在现场、转运途中或入院后经复苏恢复了自主心输出量，并且因心血管、呼吸或神经功能损害而需要进一步的重症监护支持。86例患者（86%）在重症监护病房死亡，只有14例（14%）存活至从该病房出院。另有9例（9%）患者在出院前在医院死亡。4例患者（4%）在6个月后存活，3例患者（3%）在1年后存活。57例（57%）患者接受了积极的治疗撤减，只有4例（4%）因年龄、病史或治疗撤减后至死亡的时间长度等因素未被排除，有可能适合进行器官获取。我们的结果表明，从这一人群中可能仅能使供体器官数量略有增加。需要进一步开展工作来确定此类患者是否应被视为非心脏跳动供体。
