Department of Cardiology, Azienda Ospedaliero-Universitaria and IRCAB Foundation, Udine, Italy.
Europace. 2012 Aug;14(8):1195-8. doi: 10.1093/europace/eus232.
The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies.
Fifty-three European centres, all members of the EHRA-EP Research network, completed the questions of the survey. A dedicated strategy for OHCA management is active in 85% of the centres. Shockable tachyarrhythmias such as initial OHCA rhythm are reported in >70% of the patients in 64% of the centres. In-hospital therapeutic hypothermia was applied in >50% of the patients in 53% of the centres and in <50% in 47% of the centres. In the year 2011 90% of the centres performed >10 primary percutaneous coronary angioplasties (PCI) in OHCA patients. The survival rate, when the initial documented rhythm was shockable, was >30% in 42% of the centres, and conversely, was significantly lower when asystole or pulseless electrical activity was the initial rhythm. A favourable neurological recovery was reported in >50% of the patients in 13 (26%) centres and in 21-50% of the patients in 21 (44%).
This EP wire survey demonstrates a favourable implementation in OHCA of an invasive management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused.
本 EP 研究旨在探讨院外心脏骤停（OHCA）管理领域的临床实践，特别关注院内诊断和治疗策略。
53 个欧洲中心（均为 EHRA-EP 研究网络的成员）完成了调查的问题。85%的中心采用了专门的 OHCA 管理策略。64%的中心报告>70%的患者初始 OHCA 节律为可电击性心动过速，47%的中心中>50%的患者应用了院内治疗性低温，而<50%的中心中应用了<50%的患者。2011 年，90%的中心对 OHCA 患者进行了>10 次的直接经皮冠状动脉介入治疗（PCI）。初始记录的节律为可电击性时，42%的中心的存活率>30%，而初始节律为心搏停止或无脉电活动时，存活率显著降低。13 个中心（26%）报告>50%的患者有良好的神经功能恢复，21 个中心（44%）报告 21-50%的患者有良好的神经功能恢复。
本 EP 研究表明，OHCA 中采用了包括冠状动脉造影/PCI 和植入式心脏复律除颤器治疗在内的侵袭性管理策略的实施情况良好，而治疗性低温的应用似乎不足。
