Youn Chun Song, Choi Seung Pill, Yim Hyeon Woo, Park Kyu Nam
Department of Emergency Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Resuscitation. 2009 Jul;80(7):778-83. doi: 10.1016/j.resuscitation.2009.04.007. Epub 2009 May 13.
Drowning is a unique form of cardiac arrest and is often preventable. "Utstein Style for Drowning" was published in 2003 by the International Liaison Committee on Resuscitation (ILCOR) to improve the knowledge-base, to provide epidemiological stratification, to recommend appropriate treatments and to ultimately save lives. We report on the largest single-center study of the Utstein Style resuscitation for drowning.
All patients with out-of-hospital cardiac arrest (OHCA) due to drowning admitted to St. Mary's Hospital between 1998 and 2007 were included. Utstein Style variables and other time intervals not included in the Utstein Style guidelines were evaluated for their ability to predict survival. The primary end point of this study was survival to discharge.
We enrolled 131 patients with OHCA due to drowning; 21 patients (16.03%) had survival to discharge and 9 patients (6.87%) were discharged with a good neurologic outcome, i.e., cerebral performance categories (CPC) of 1 or 2. For the Utstein Style variables witnessed, the duration of submersion and the time of first emergency medical systems (EMS) resuscitation attempt influenced survival. For other time intervals, the transportation time (i.e., time interval from witnessing of the drowning to EMS arrival at the hospital, or if events were not witnessed, the time interval from calling the EMS to EMS arrival at the hospital), the duration of advanced cardiovascular life support (ACLS) and the duration of total arrest time were associated with survival.
Our report is the largest single-center study of OHCA due to drowning reported according to the guidelines of the Utstein Style. Being witnessed, having a short duration of submersion, having early resuscitation by EMS, and rapid transportation are important for survival after drowning.
溺水是心脏骤停的一种特殊形式，且通常是可预防的。国际复苏联合会（ILCOR）于2003年发布了“溺水的Utstein模式”，以增进相关知识储备，提供流行病学分层，推荐合适的治疗方法并最终挽救生命。我们报告了关于溺水的Utstein模式复苏的最大规模单中心研究。
纳入1998年至2007年间因溺水导致院外心脏骤停（OHCA）并入住圣玛丽医院的所有患者。评估Utstein模式变量以及Utstein模式指南未涵盖的其他时间间隔对预测生存的能力。本研究的主要终点是出院生存。
我们纳入了131例因溺水导致OHCA的患者；21例患者（16.03%）出院生存，9例患者（6.87%）出院时神经功能良好，即脑功能分类（CPC）为1或2。对于Utstein模式变量目击情况、淹没持续时间和首次紧急医疗服务（EMS）复苏尝试时间影响生存。对于其他时间间隔，转运时间（即从目睹溺水到EMS到达医院的时间间隔，或者如果事件未被目睹，则从呼叫EMS到EMS到达医院的时间间隔）、高级心血管生命支持（ACLS）持续时间和总骤停时间与生存相关。
我们的报告是根据Utstein模式指南报告的关于因溺水导致OHCA的最大规模单中心研究。被目击、淹没持续时间短、由EMS进行早期复苏以及快速转运对于溺水后生存很重要。
