北欧国家院外心脏骤停患者的复苏后护理：一项问卷调查研究。
Post resuscitation care of out-of-hospital cardiac arrest patients in the Nordic countries: a questionnaire study.
作者信息
Saarinen Sini, Castrén Maaret, Virkkunen Ilkka, Kämäräinen Antti
机构信息
Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and Helsinki University, PL 281, 00029, Helsinki, Finland.
Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
出版信息
Scand J Trauma Resusc Emerg Med. 2015 Aug 22;23:60. doi: 10.1186/s13049-015-0141-z.
BACKGROUND
Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs).
METHODS
An online questionnaire was sent to Nordic ICUs in 2012 and was complemented by an additional one in 2014.
RESULTS
The first questionnaire was sent to 188 and the second one to 184 ICUs. Response rates were 51 % and 46 %. In 2012, 37 % of the ICUs treated all patients resuscitated from OHCA with targeted temperature management (TTM) at 33 °C. All OHCA patients admitted to the ICU were treated with TTM at 33 °C more often in Norway (69 %) compared to Finland (20 %) and Sweden (25 %), p 0.02 and 0.014. In 2014, 63 % of the ICUs still use TTM at 33 °C, but 33 % use TTM at 36 °C. Early coronary angiography (CAG) and possible percutaneous coronary intervention (PCI) was routinely provided for all survivors of OHCA in 39 % of the hospitals in 2012 and in 28 % of the hospitals in 2014. Routine CAG for all actively treated victims of OHCA was performed more frequently in Sweden (51 %) and in Norway (54 %) compared to Finland (13 %), p 0.014 and 0.042.
CONCLUSIONS
Since 2012, TTM at 36 °C has been implemented in some ICUs, but TTM at 33 °C is used in majority of the ICUs. TTM at 33 or 36 °C and primary CAG are not routinely provided for all OHCA survivors and the criteria for these and ICU admission are variable. Best practices as a uniform approach to the optimal care of the resuscitated patient should be sought in the Nordic Countries.
背景
本研究旨在比较北欧（丹麦、芬兰、冰岛、挪威、瑞典）重症监护病房（ICU）中院外心脏骤停（OHCA）患者的复苏后护理情况。
方法
2012年向北欧ICU发送了一份在线问卷，并于2014年补充了另一份问卷。
结果
第一份问卷发送给了188个ICU，第二份问卷发送给了184个ICU。回复率分别为51%和46%。2012年，37%的ICU对所有从OHCA复苏的患者采用33℃的目标温度管理（TTM）进行治疗。与芬兰（20%）和瑞典（25%）相比，挪威（69%）对所有入住ICU的OHCA患者采用33℃的TTM治疗更为频繁，p值分别为0.02和0.014。2014年，63%的ICU仍采用33℃的TTM，但33%采用36℃的TTM。2012年，39%的医院对所有OHCA幸存者常规进行早期冠状动脉造影（CAG）及可能的经皮冠状动脉介入治疗（PCI），2014年这一比例为28%。与芬兰（13%）相比，瑞典（51%）和挪威（54%）对所有积极治疗的OHCA受害者进行常规CAG的频率更高，p值分别为0.014和0.042。
结论
自2012年以来，一些ICU采用了36℃的TTM，但大多数ICU仍采用33℃的TTM。并非对所有OHCA幸存者都常规提供33℃或36℃的TTM以及初级CAG，这些以及ICU入院的标准各不相同。北欧国家应寻求作为复苏患者最佳护理统一方法的最佳实践。
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