Ali Bakhtiar, Zafari A Maziar
Atlanta Veterans Affairs Medical Center, Decatur, Georgia 30033, USA.
Ann Intern Med. 2007 Aug 7;147(3):171-9. doi: 10.7326/0003-4819-147-3-200708070-00006.
Sudden cardiac death is a major clinical problem, causing 300,000 to 400,000 deaths annually and 63% of all cardiac deaths. Despite the overall decrease in cardiovascular mortality, the proportion of cardiovascular death from sudden cardiac death has remained constant. Survival rates among patients who have out-of-hospital cardiac arrest vary from 5% to 18%, depending on the presenting rhythm. The latest guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care published by the American Heart Association include substantial changes to the algorithms for basic life support and advanced cardiovascular life support. For unwitnessed cardiac arrest, immediate defibrillation of the patient is no longer recommended. Rather, 2 minutes of CPR before defibrillation is now recommended. People in cardiac arrest should no longer receive stacked shocks. The compression-ventilation ratio has been changed from 15:2 to 30:2. This article is a contemporary review of the management of CPR and emergency cardiovascular care. It examines current practice and data supporting use of CPR, along with changes in the management of sudden cardiac death.
心源性猝死是一个重大的临床问题，每年导致30万至40万人死亡，占所有心脏性死亡的63%。尽管心血管疾病死亡率总体呈下降趋势，但心源性猝死导致的心血管死亡比例一直保持稳定。院外心脏骤停患者的生存率在5%至18%之间，具体取决于初始心律。美国心脏协会发布的最新心肺复苏（CPR）和心血管急救指南对基础生命支持和高级心血管生命支持算法做出了重大改变。对于未被目击的心脏骤停，不再建议立即对患者进行除颤。相反，现在建议在除颤前先进行2分钟的心肺复苏。心脏骤停患者不应再接受连续电击。按压与通气比例已从15:2改为30:2。本文是对心肺复苏和心血管急救管理的当代综述。它审视了当前的实践以及支持使用心肺复苏的数据，以及心源性猝死管理方面的变化。
