Kaernested Bylgja, Indridason Olafur Skúli, Baldursson Jón, Arnar Davíd O
Landspítala Hringbraut, Reykavík.
Laeknabladid. 2009 Jul-Aug;95(7-8):509-14.
Survival after in-hospital cardiac arrest has not been previously reported in Iceland and the purpose of this study was to examine the outcomes of in-hospital resuscitation over a two year period.
There are resuscitation teams on each of the two campuses of the University Hospital in Reykjavik. Since the beginning of 2006, the resuscitation teams have compiled their reports in a structured form, Utstein style.
During 2006 and 2007 resuscitation teams were activated on a total of 311 occasions. Of those, there was need for a full cardiopulmonary resuscitation because of cardiac arrest of in patients in 80 cases (26%). Return of spontaneous circulation was achieved or the patient survived to be transferred to the intensive care unit in 55 (69%) of the 80 cases. Survival to discharge was 33%. Survival to discharge was better if the arrest occurred between 8 AM and 4 PM during daytime (50%), than outside of regular working hours (23%, p=0.02). The survival was better if ventricular tachycardia or fibrillation was the first rhythm encountered (50%) than if the initial rhythm turned out to be asystole or pulseless electrical activity (12%, p=0.002). Those who survived resuscitation were generally younger than those who did not (p=0.002).
The outcomes were similar to those reported at institutions in our neighboring countries. The survival rate was lower if the cardiac arrest occurred outside of regular working hours and if ventricular tachycardia or fibrillation was the first encountered rhythm.
冰岛此前尚未报道过院内心脏骤停后的存活情况,本研究旨在调查两年期间院内心脏复苏的结果。
雷克雅未克大学医院的两个院区均设有复苏团队。自2006年初以来,复苏团队一直以结构化的Utstein格式编写报告。
2006年至2007年期间,复苏团队共被激活311次。其中,80例(26%)住院患者因心脏骤停需要进行完整的心肺复苏。80例中有55例(69%)实现了自主循环恢复或患者存活并被转至重症监护病房。出院存活率为33%。如果心脏骤停发生在白天上午8点至下午4点之间,出院存活率更高(50%),高于正常工作时间之外(23%,p=0.02)。如果最初遇到的心律是室性心动过速或心室颤动,存活率更高(50%),高于最初心律为心脏停搏或无脉电活动的情况(12%,p=0.002)。复苏成功存活的患者通常比未存活的患者年轻(p=0.002)。
结果与邻国机构报告的结果相似。如果心脏骤停发生在正常工作时间之外,且最初遇到的心律是室性心动过速或心室颤动,则存活率较低。