Patel Jignesh K, Chabra Vikram, Parnia Sam
Resuscitation Research Group, Division of Pulmonary and Critical Care Medicine, Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York, USA.
Curr Opin Crit Care. 2015 Oct;21(5):453-9. doi: 10.1097/MCC.0000000000000237.
To provide a summary of the recent literature on clinical outcomes in adults with cardiac arrest, focusing on the impact of patient-specific factors in combination with cardio-pulmonary resuscitation (CPR) related, and postresuscitative-related factors.
Cardiac arrest is a major cause of morbidity and mortality worldwide. Despite the use of conventional cardiopulmonary resuscitation, rates of return of spontaneous circulation and survival with minimal neurologic impairment remain low. A number of recent studies have examined the impact of patient-specific factors (duration of cardiac arrest, initial rhythm, age, premorbid states), CPR-related (the use of mechanical CPR, the use of impedance threshold device, vasopressors, extra-corporeal membrane oxygenation, active compression-decompression, and impedance threshold device), and postresuscitative-related factors (hypothermia, coronary angiography, hyperoxia, hyper/hypocapnia, mean arterial blood pressure) on cardiac arrest outcomes.
Further studies, namely randomized controlled trials, assessing the impact of advanced therapies are warranted to evaluate their impact on survival and neurologic function in adults with cardiac arrest.
总结近期关于成人心脏骤停临床结局的文献,重点关注患者特异性因素与心肺复苏(CPR)相关因素及复苏后相关因素相结合的影响。
心脏骤停是全球发病和死亡的主要原因。尽管使用了传统的心肺复苏,但自主循环恢复率和伴有最小神经功能障碍的生存率仍然很低。最近的一些研究探讨了患者特异性因素(心脏骤停持续时间、初始心律、年龄、病前状态)、CPR相关因素(机械CPR的使用、阻抗阈值装置的使用、血管加压药、体外膜肺氧合、主动按压-减压和阻抗阈值装置)以及复苏后相关因素(低温、冠状动脉造影、高氧、高/低碳酸血症、平均动脉血压)对心脏骤停结局的影响。
有必要进行进一步的研究,即随机对照试验,以评估高级治疗方法的影响,从而评估它们对成人心脏骤停患者生存和神经功能的影响。