AP-HP, Urgences-Samu 93, Hôpital Avicenne, Université Paris 13, 93000, Bobigny, France.
Intensive Care Med. 2014 Jul;40(7):981-7. doi: 10.1007/s00134-014-3337-1. Epub 2014 May 23.
To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option.
Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief.
Among the 570 family members [intention to treat (ITT) population], 408 (72%) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95% confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95% CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23%; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24%; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21%; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23%; P = 0.003).
At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.
评估在心肺复苏术(CPR)期间让亲属选择是否在场的心理后果,与常规不提供该选择的情况进行比较。
这是一项前瞻性、整群随机、对照试验,涉及法国的 15 个院前急救医疗服务单位,比较了系统地邀请亲属见证 CPR 与传统做法(570 名家属)。主要观察指标是 1 年评估,包括 PTSD、焦虑和抑郁症状以及/或复杂悲伤的比例。
在 570 名家属中(意向治疗人群),有 408 名(72%)在 1 年时进行了评估。在意向治疗人群(N=570)中,与对照组相比,干预组中出现 PTSD 相关症状的家属更为常见[调整后的优势比,1.8;95%置信区间(CI)1.1-3.0;P=0.02],而医生未建议其见证 CPR 的家属也是如此[调整后的优势比,1.7;95%CI 1.1-2.6;P=0.02]。在观察病例人群(N=408)中,对照组中出现重度抑郁发作的家属比例明显更高(31% vs. 23%;P=0.02),而医生未建议其见证 CPR 的家属比例也是如此(31% vs. 24%;P=0.03)。对照组中出现复杂悲伤的比例明显更高(36% vs. 21%;P=0.005),而医生未建议其见证复苏的家属比例也是如此(37% vs. 23%;P=0.003)。
在事件发生后 1 年,对于那些被给予选择是否见证亲属心脏骤停 CPR 的家属来说,心理获益仍然存在。