Department of Anaesthesia and Intensive Care, Helsinki University Central Hospital, Hyvinkää Hospital, Sairaalankatu 1, 05850 Hyvinkää, Finland.
Resuscitation. 2012 Jul;83(7):819-22. doi: 10.1016/j.resuscitation.2011.12.018. Epub 2011 Dec 29.
We aimed to document how often patients received appropriate treatment of the primary cause underlying pulseless electrical activity (PEA) during cardiopulmonary resuscitation (CPR) and how it affected their outcome.
Data were collected between 2003 and 2010 in Finland and Sweden. All adult patients who underwent in-hospital cardiac arrest (IHCA) with PEA as the initial rhythm were included, if CPR was attempted. Patients were divided into two groups: those who received appropriate treatment of the primary cause during CPR (treatment of the primary cause group) and those who received conventional CPR (non-specific treatment group). Survival between groups was compared and a multivariable logistic regression analysis was performed to exclude the effect of possible confounders.
Of 104 study patients, 19 (18%) received treatment of the primary cause and 85 (82%) received non-specific treatment. 30-Days survival of patients in treatment of primary cause group was superior compared to patients in the non-specific treatment group: 6 (32%) vs. 9 (11%) were alive 30 days after IHCA, p=0.03. Multivariable analysis suggested that treatment of the primary cause improves the odds of survival 2.5-fold, but this was not statistically significant. Age was the only significant independent prognostic factor for 30-days survival.
During CPR, only a fifth of patients received appropriate treatment of the primary cause underlying PEA. Those patients were more likely to be alive 30 days after IHCA, but age turned out to be the only significant individual factor for better survival.
本研究旨在记录在心肺复苏（CPR）过程中，患者接受潜在电活动（PEA）首要病因适当治疗的频率，以及其对预后的影响。
研究数据收集于 2003 年至 2010 年在芬兰和瑞典进行。所有接受院内心脏骤停（IHCA）且初始节律为 PEA 并进行 CPR 的成年患者均纳入研究。患者分为两组：CPR 期间接受首要病因适当治疗（治疗首要病因组）和接受常规 CPR（非特异性治疗组）。比较两组之间的存活率，并进行多变量逻辑回归分析以排除可能的混杂因素的影响。
在 104 例研究患者中，19 例（18%）接受了首要病因治疗，85 例（82%）接受了非特异性治疗。治疗首要病因组患者 30 天存活率优于非特异性治疗组：30 天后存活的患者中，治疗组有 6 例（32%），而非特异性治疗组有 9 例（11%），p=0.03。多变量分析表明，治疗首要病因可使存活的几率提高 2.5 倍，但无统计学意义。年龄是 30 天存活率的唯一显著独立预后因素。
在 CPR 过程中，仅有五分之一的患者接受了 PEA 潜在病因的适当治疗。这些患者在 IHCA 后 30 天存活的可能性更高，但年龄是唯一对存活有显著影响的个体因素。
