尼科西亚综合医院心脏骤停团队：院内复苏第一年的实践与结果

Eftychiou Christos, Georgiou Marios, Andreou Andreas, Michaelides Andreas, Yiangou Kyriakos, Deligeorgis Alexandros, Petrou Petros, Georgiou Panayiota, Christodoulides Theodoros, Makri Loukia, Georgiou Evanthia, Patsia Thalia, Nicolaides Evagoras, Minas Michalis

Cardiology Department, Cyprus.

Hellenic J Cardiol. 2009 Jul-Aug;50(4):264-8.

INTRODUCTION

In 2007, Nicosia General Hospital implemented a resuscitation policy. 378 nurses and 120 doctors were successfully trained in advanced life support (ALS) in order to staff cardiac arrest teams. The aim of this study was to assess the frequency of cardiac arrest and resuscitation outcomes in Nicosia General Hospital and assess any associations between the survival rate and the patient's characteristics. We also aimed to evaluate the effectiveness of in-hospital resuscitation in order to detect ways of improvement.

METHODS

We prospectively analyzed the data on all cardiac arrest calls in Nicosia General Hospital between January and December 2007. Data were collected using the Utstein style.

RESULTS

The cardiac arrest team (CAT) was called 83 times, of which 10 were false alarms. Cardiac arrest was identified in 69 calls, while 4 calls were respiratory arrests. The patients' mean age was 70.8 years (95% CI: 66.6-75.1). In 86% the initial rhythm was asystole/pulseless electrical activity (PEA) and in 14% ventricular fibrillation/tachycardia (VF/VT). Return of spontaneous circulation was achieved in 52% of the cases. Survival to discharge was achieved in 17.8% of the patients with arrest and in 14.5% of cardiac arrests. Patients with an initial rhythm of asystole/PEA were discharged in 5% and patients with VF/VT in 70% of cases. About 36% of the patients less than 60 years old and 12% of the patients older than 60 were discharged. The CAT arrived within 1.6 minutes, first shock in VF/VT was delivered within 1.5 minutes and the first adrenaline dose in asystole/PEA was given within 2.7 minutes.

CONCLUSIONS

It is more likely for our patients to survive to discharge if they are less than 60 years old, they are hospitalized in the cardiology department and the initial rhythm is VF/VT. Our outcomes are similar to survival rates in larger studies. However, points of improvement have been identified and interventions need to be made in order to improve documentation and outcomes of in-hospital arrests.

引言

2007年，尼科西亚综合医院实施了一项复苏政策。378名护士和120名医生成功接受了高级生命支持（ALS）培训，以便为心脏骤停团队配备人员。本研究的目的是评估尼科西亚综合医院心脏骤停的发生率和复苏结果，并评估生存率与患者特征之间的任何关联。我们还旨在评估院内复苏的有效性，以发现改进方法。

方法

我们前瞻性分析了2007年1月至12月期间尼科西亚综合医院所有心脏骤停呼叫的数据。数据采用乌斯坦风格收集。

结果

心脏骤停团队（CAT）接到呼叫83次，其中10次为误报。在69次呼叫中识别出心脏骤停，4次为呼吸骤停。患者的平均年龄为70.8岁（95%可信区间：66.6 - 75.1）。86%的患者初始心律为心搏停止/无脉电活动（PEA），14%为室颤/室速（VF/VT）。52%的病例实现了自主循环恢复。心脏骤停患者中有17.8%存活至出院，心脏骤停事件中有14.5%存活至出院。初始心律为心搏停止/PEA的患者5%存活至出院，VF/VT患者70%存活至出院。60岁以下患者约36%存活至出院，60岁以上患者12%存活至出院。CAT在1.6分钟内到达，VF/VT患者首次电击在1.5分钟内进行，心搏停止/PEA患者首次肾上腺素剂量在2.7分钟内给予。