Hendrick J M, Pijls N H, van der Werf T, Crul J F
St. Radboud Hospital, Department of Cardiology, Nijmegen, The Netherlands.
Resuscitation. 1990 Oct;20(2):163-71. doi: 10.1016/0300-9572(90)90051-f.
In this study 91 consecutive CPR cases in 90 patients on general wards were evaluated during 18 months. Fifteen patients (16.5%) could be discharged, which is relatively favourable in comparison to the literature. Children proved to have a better chance to leave the hospital alive than adults (6/18 vs. 9/72; P less than 0.05). No factors with negative predictive value before the cardiopulmonary arrest could be isolated. Even oncological patients, often described as a prognostically poor category, with a success rate of 27% (6/22) did not differ from other categories. Patients with isolated respiratory arrest, ventricular tachycardia or ventricular fibrillation at the arrival of the CPR-team had a better chance to be discharged from the hospital. A rapid decrease in survival was noted if a CPR attempt lasted longer than 10 min (P less than 0.001). When there is no return of vital signs within 30 min the CPR attempt can be stopped. During follow-up period (mean 6 month) 2 of the 15 survivors (13.3%) died from a non-cardiopulmonary cause. It is concluded that no category of patients can be excluded from CPR in advance. Although ultimate success rate for CPR in the general wards will rarely exceed 15%, CPR has to be initiated in most cases of cardiopulmonary arrest.
在本研究中，对90例普通病房患者连续91例心肺复苏（CPR）病例进行了为期18个月的评估。15例患者（16.5%）得以出院，与文献相比这一结果相对较好。事实证明，儿童比成人有更高的存活出院几率（6/18 vs. 9/72；P<0.05）。在心脏骤停前未发现具有负面预测价值的因素。即使是通常被认为预后较差的肿瘤患者，其成功率为27%（6/22），与其他类别患者并无差异。CPR团队到达时出现单纯呼吸骤停、室性心动过速或心室颤动的患者有更高的出院几率。如果CPR尝试持续超过10分钟，存活率会迅速下降（P<0.001）。若30分钟内无生命体征恢复，可停止CPR尝试。在随访期（平均6个月）内，15名幸存者中有2例（13.3%）死于非心肺原因。结论是，没有哪一类患者可以提前被排除在CPR之外。尽管普通病房CPR的最终成功率很少会超过15%，但在大多数心脏骤停病例中仍必须启动CPR。
