Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Am J Emerg Med. 2010 Mar;28(3):310-7. doi: 10.1016/j.ajem.2008.12.018.
The study aimed to determine the factors predictive of sustained return of spontaneous circulation (ROSC) in children with out-of-hospital cardiac arrest (OHCA) of noncardiac origin.
Eighty children were included in this retrospective study. The variables that lead to sustained ROSC and those that do not lead to sustained ROSC were analyzed. Survival analyses, including chance of achieving sustained ROSC and sum duration of ROSC, were conducted according to the duration of in-hospital cardiopulmonary resuscitation (CPR).
Etiologies of noncardiac OHCA differed significantly across different age groups (P < .001). Only 8.8% of children had initial arrest rhythms that were shockable. Predictors of sustained ROSC included the initial cardiac rhythm (P = .002), a shorter period between collapse and the first chest compression (P = .002), a shorter in-hospital CPR duration (P = .004), and prehospital CPR (P = .007). In children where ROSC was initially sustained, those with in-hospital CPR of more than 20 minutes, ROSC was sustained for less time (P < .001).
Few children with noncardiac OHCA present with shockable cardiac rhythms. Furthermore, long-term ROSC is difficult to maintain in children who receive in-hospital CPR for more than 20 minutes.
本研究旨在确定非心源性院外心脏骤停（OHCA）患儿中预测自主循环持续恢复（ROSC）的因素。
本回顾性研究纳入了 80 名患儿。分析了导致持续 ROSC 和不导致持续 ROSC 的变量。根据院内心肺复苏（CPR）持续时间，进行生存分析，包括实现持续 ROSC 的机会和 ROSC 持续时间的总和。
不同年龄组的非心源性 OHCA 的病因差异有统计学意义（P <.001）。仅有 8.8%的患儿初始停搏节律为可除颤性。持续 ROSC 的预测因素包括初始心搏节律（P =.002）、从倒下到第一次胸外按压的时间间隔较短（P =.002）、院内 CPR 持续时间较短（P =.004）和院外 CPR（P =.007）。在初始 ROSC 持续的患儿中，院内 CPR 超过 20 分钟者，ROS 持续时间较短（P <.001）。
非心源性 OHCA 患儿中，出现可除颤心搏节律的患儿较少。此外，接受院内 CPR 超过 20 分钟的患儿，很难维持长期 ROSC。
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