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北京地区住院儿童青少年心搏骤停的流行病学和复苏效果:一项观察性研究。

The epidemiology and resuscitation effects of cardiopulmonary arrest among hospitalized children and adolescents in Beijing: an observational study.

机构信息

Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, Beijing, China.

出版信息

Resuscitation. 2013 Dec;84(12):1685-90. doi: 10.1016/j.resuscitation.2013.08.007. Epub 2013 Aug 21.

Abstract

AIM

To investigate the epidemiology and resuscitation effects of cardiopulmonary arrest among hospitalized children and adolescents in Beijing.

METHODS

A prospective multicentre study was conducted in four hospitals in urban/suburban areas of Beijing. Patients aged 1 month-18 years with cardiopulmonary arrest and received cardiopulmonary resuscitation (CPR) who were consecutively hospitalised during the study period (1 September 2008-31 December 2010) were enrolled. Data was collected and analyzed using the "in-hospital Utstein style". Neurological outcome was assessed with the pediatric cerebral performance category (PCPC) among patients who survived.

RESULT

201 of 108,673 hospitalized patients (0.18%) had cardiopulmonary arrest during their hospitalization. Of these, 174 patients underwent CPR. The most common causes of cardiopulmonary arrest were the diseases of respiratory system (29.3%) and circulatory system (19.0%). The most common initial rhythm was bradycardia (72.4%). About 108 patients (62.1%) had restoration of spontaneous circulation (ROSC). Forty-nine patients (28.2%) survived to hospital discharge, 25 (14.5%) survived 6 months post discharge, and 21 (12.1%) survived 1 year post discharge. Out of the 21 patients who survived 1 year after hospital discharge, 18 had good neurological outcome. Multivariate logistic regression analysis showed age, duration of CPR and endotracheal intubation performed before cardiopulmonary arrest were independent factors of cardiopulmonary resuscitation effect.

CONCLUSION

The prevalence of in-hospital cardiopulmonary arrest in children and adolescents is low. The long-term result of children and adolescents survived from cardiopulmonary resuscitation is quite good. Age, CPR duration and endotracheal intubation performed before cardiopulmonary arrest were independent factors of cardiopulmonary resuscitation effect.

摘要

目的

调查北京住院儿童和青少年心搏骤停的流行病学和复苏效果。

方法

本研究采用前瞻性多中心研究,在北京四家城市/城乡地区的医院进行。连续纳入 2008 年 9 月 1 日至 2010 年 12 月 31 日期间住院且发生心搏骤停并接受心肺复苏(CPR)的 1 个月至 18 岁患者。采用“院内乌斯太风格”收集和分析数据。对存活患者进行小儿脑功能分类(PCPC)评估神经功能预后。

结果

108673 例住院患者中有 201 例(0.18%)发生心搏骤停,其中 174 例行 CPR。心搏骤停最常见的病因是呼吸系统疾病(29.3%)和循环系统疾病(19.0%)。最常见的初始节律是心动过缓(72.4%)。约 108 例(62.1%)患者恢复自主循环(ROSC)。49 例(28.2%)存活至出院,25 例(14.5%)出院后 6 个月存活,21 例(12.1%)出院后 1 年存活。出院后存活 1 年的 21 例患者中,18 例神经功能预后良好。多变量逻辑回归分析显示,年龄、CPR 持续时间和心搏骤停前进行的气管插管是心肺复苏效果的独立因素。

结论

住院儿童和青少年心搏骤停的发生率较低。心肺复苏后存活的儿童和青少年的长期预后相当好。年龄、CPR 持续时间和心搏骤停前进行的气管插管是心肺复苏效果的独立因素。

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