麻醉相关心搏骤停。

Anesthesia-related cardiac arrest.

机构信息

From the Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska (S.J.E., M.C.N., J.A.S., K.R.P., J.H.T., S.J.L.); Veterans Affairs Nebraska Western-Iowa Healthcare System, and Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska (D.J.R.); Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska (D.W.M.); Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (R.L.H.); Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas (J.D.K.); and Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska (F.Q.).

出版信息

Anesthesiology. 2014 Apr;120(4):829-38. doi: 10.1097/ALN.0000000000000153.

DOI:10.1097/ALN.0000000000000153

PMID:24496124

Abstract

BACKGROUND

Much is still unknown about the actual incidence of anesthesia-related cardiac arrest in the United States.

METHODS

The authors identified all of the cases of cardiac arrest from their quality improvement database from 1999 to 2009 and submitted them for review by an independent study commission to give them the best estimate of anesthesia-related cardiac arrest at their institution. One hundred sixty perioperative cardiac arrests within 24 h of surgery were identified from an anesthesia database of 217,365 anesthetics. An independent study commission reviewed all case abstracts to determine which cardiac arrests were anesthesia-attributable or anesthesia-contributory. Anesthesia-attributable cardiac arrests were those cases in which anesthesia was determined to be the primary cause of cardiac arrest. Anesthesia-contributory cardiac arrests were those cases where anesthesia was determined to have contributed to the cardiac arrest.

RESULTS

Fourteen cardiac arrests were anesthesia-attributable, resulting in an incidence of 0.6 per 10,000 anesthetics (95% CI, 0.4 to 1.1). Twenty-three cardiac arrests were found to be anesthesia-contributory resulting in an incidence of 1.1 per 10,000 anesthetics (95% CI, 0.7 to 1.6). Sixty-four percent of anesthesia-attributable cardiac arrests were caused by airway complications that occurred primarily with induction, emergence, or in the postanesthesia care unit, and mortality was 29%. Anesthesia-contributory cardiac arrest occurred during all phases of the anesthesia, and mortality was 70%.

CONCLUSION

As judged by an independent study commission, anesthesia-related cardiac arrest occurred in 37 of 160 cardiac arrests within the 24-h perioperative period.

摘要

背景

在美国，有关麻醉相关心搏骤停的确切发生率，人们仍知之甚少。

方法

作者从其 1999 年至 2009 年的质量改进数据库中确定了所有心搏骤停病例，并将其提交给一个独立的研究委员会进行审查，以对其机构内与麻醉相关的心搏骤停做出最佳估计。从一个包含 217365 例麻醉的麻醉数据库中，发现了 160 例术后 24 小时内的围手术期心搏骤停。一个独立的研究委员会审查了所有病例摘要，以确定哪些心搏骤停是麻醉相关的或麻醉促成的。麻醉相关心搏骤停是指麻醉被确定为心搏骤停的主要原因的病例。麻醉促成的心搏骤停是指麻醉被确定为促成心搏骤停的病例。

结果

有 14 例心搏骤停是麻醉相关的，发生率为每 10000 次麻醉 0.6 例（95%CI，0.4 至 1.1）。发现有 23 例心搏骤停是麻醉促成的，发生率为每 10000 次麻醉 1.1 例（95%CI，0.7 至 1.6）。64%的麻醉相关心搏骤停是由气道并发症引起的，这些并发症主要发生在诱导、苏醒或麻醉后护理单元，死亡率为 29%。麻醉促成的心搏骤停发生在麻醉的所有阶段，死亡率为 70%。