Bergum Daniel, Nordseth Trond, Mjølstad Ole Christian, Skogvoll Eirik, Haugen Bjørn Olav
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Anaesthesia and Intensive Care Medicine, St. Olav University Hospital, Trondheim, Norway; Norwegian Air Ambulance Foundation, Norway.
Department of Anaesthesia and Intensive Care Medicine, St. Olav University Hospital, Trondheim, Norway; Norwegian Air Ambulance Foundation, Norway.
Resuscitation. 2015 Feb;87:63-8. doi: 10.1016/j.resuscitation.2014.11.007. Epub 2014 Nov 27.
Do emergency teams (ETs) consider the underlying causes of in-hospital cardiac arrest (IHCA) during advanced life support (ALS)? In a 4.5-year prospective observational study, an aetiology study group examined 302 episodes of IHCA. The purpose was to investigate the causes and cause-related survival and to evaluate whether these causes were recognised by the ETs.
In 258 (85%) episodes, the cause of IHCA was reliably determined. The cause was correctly recognised by the ET in 198 of 302 episodes (66%). In the majority of episodes, cardiac causes (156, 60%) or hypoxic causes (51, 20%) were present. The cause-related survival was 30% for cardiac aetiology and 37% for hypoxic aetiology. The initial cardiac rhythm was pulseless electrical activity (PEA) in 144 episodes (48%) followed by asystole in 70 episodes (23%) and combined ventricular fibrillation/ventricular tachycardia (VF/VT) in 83 episodes (27%). Seventy-one patients (25%) survived to hospital discharge. The median delay to cardiopulmonary resuscitation (CPR) was 1min (inter-quartile range 0-1min).
Various cardiac and hypoxic aetiologies dominated. In two-thirds of IHCA episodes, the underlying cause was correctly identified by the ET, i.e. according to the findings of the aetiology study group.
在高级生命支持（ALS）期间，急救团队（ETs）是否会考虑院内心脏骤停（IHCA）的潜在病因？在一项为期4.5年的前瞻性观察研究中，一个病因研究小组对302例IHCA事件进行了检查。目的是调查病因及与病因相关的生存率，并评估这些病因是否被急救团队识别。
在258例（85%）事件中，IHCA的病因得以可靠确定。急救团队在302例事件中的198例（66%）中正确识别了病因。在大多数事件中，存在心脏病因（156例，60%）或缺氧病因（51例，20%）。心脏病因的病因相关生存率为30%，缺氧病因的为37%。初始心律为无脉电活动（PEA）的有144例（48%），其次是心搏停止70例（23%），心室颤动/室性心动过速（VF/VT）合并83例（27%）。71名患者（25%）存活至出院。心肺复苏（CPR）的中位延迟时间为1分钟（四分位间距0 - 1分钟）。
各种心脏和缺氧病因占主导。在三分之二的IHCA事件中，急救团队正确识别了潜在病因，即根据病因研究小组的调查结果。
