Schüttler J, Bartsch A C, Bremer F, Ebeling B J, Födisch M, Kulka P, Pflitsch D
Institut für Anästhesiologie, Rheinische Friedrich-Wilhelms-Universität Bonn.
Anasth Intensivther Notfallmed. 1990 Oct;25(5):340-7.
Survival rates following cardiopulmonary resuscitation differ widely with regard to the diverse rescue systems where the investigations were performed, and also with regard to the different patient populations. From 1981 to 1986, 1037 patients with out-of-hospital cardiac arrest were investigated in the city of Bonn. It was the purpose of this study to differentiate between various patient populations and to analyze factors which are responsible for CPR success. Survival rates following CPR could be increased from 8% in 1981 to 23% in 1984. Thereafter, a relatively stable survival rate of 20.1 +/- 1.7% with an initial CPR success rate of 62.5 +/- 8.1% was observed. Patients with ventricular fibrillation showed significantly higher survival rates (33.2 +/- 2.9%) when compared to asystolic victims (11.3 +/- 1.9%). The worst results were seen in these patients where CPR was initiated following trauma (8%) or in paediatric patients (8%). Factors which significantly determine survival following CPR are: initial ECG finding, therapeutic delay with regard to bystander-initiated basic life support, as well as advanced life support by emergency physicians. In addition, well standardized therapeutical strategies are of importance with early defibrillation, rapid endotracheal intubation and swift epinephrine application mostly by endobronchial administration.
在进行调查的不同急救系统中，以及针对不同的患者群体，心肺复苏后的存活率差异很大。1981年至1986年期间，对波恩市1037例院外心脏骤停患者进行了调查。本研究的目的是区分不同的患者群体，并分析导致心肺复苏成功的因素。心肺复苏后的存活率可从1981年的8%提高到1984年的23%。此后，观察到相对稳定的存活率为20.1±1.7%，初始心肺复苏成功率为62.5±8.1%。与心搏停止的患者（11.3±1.9%）相比，心室颤动患者的存活率显著更高（33.2±2.9%）。在因创伤后开始心肺复苏的患者（8%）或儿科患者（8%）中，结果最差。显著决定心肺复苏后存活率的因素包括：初始心电图表现、旁观者启动基本生命支持的治疗延迟，以及急诊医生的高级生命支持。此外，标准化的治疗策略也很重要，包括早期除颤、快速气管插管以及大多通过支气管内给药迅速应用肾上腺素。
