Singh Swati, Grewal Anju, Gautam Parshotam L, Luthra Neeru, Tanwar Gayatri, Kaur Amarpreet
Senior Resident, Department of Anaesthesiology, Government Medical College and Hospital , Chandigarh, Punjab, India .
Assistant Professor, Department of Anaesthesiology and Resuscitation, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
J Clin Diagn Res. 2016 Jan;10(1):UC01-4. doi: 10.7860/JCDR/2016/14773.7012. Epub 2016 Jan 1.
Cardiac arrest continues to be a common cause of in-hospital deaths. Even small improvements in survival can translate into thousands of lives saved every year.
The aim of our prospective observational study was to elicit the outcomes and predictors of in-hospital cardiopulmonary resuscitation among adult patients.
All in-hospital adult patients (age >14) who suffered cardiac arrest & were attended by a Code Blue Team between 1(st) January 2012 & 30(th) April 2013 were part of the study.
The cardiopulmonary resuscitation (CPR) was assessed in terms of: Response time, Presenting initial rhythm, Time to first defibrillation, Duration of CPR and Outcome (Return of spontaneous circulation (ROSC), Glasgow outcome scale (GOS) at discharge).
Age, GOS and mean response time were analysed using t-test and ANOVA. Logistic regression was applied to determine the significance of the various factors in determining mortality.
ROSC was achieved in 44% of a total of 127 patients included in our study. Asystole/Pulseless electrical activity (PEA) was the most common presenting rhythm (87.5%). The survival to discharge was seen in 7.1% patients of whom only 3.9% patients had good neurological outcome. Regression and survival analysis depicted achievement of ROSC during CPR, absence of co-morbidities and shorter response time of code blue team as predictors of good outcome.
We found poor outcome of CPR after in-hospital cardiac arrest. This was mainly attributed to an initial presenting rhythm of Asystole/PEA in most cases and delayed response times.
心脏骤停仍然是院内死亡的常见原因。即使生存率有微小提高,每年也能挽救数千人的生命。
我们这项前瞻性观察性研究的目的是得出成年患者院内心肺复苏的结果及预测因素。
2012年1月1日至2013年4月30日期间,所有在院内发生心脏骤停并由蓝色急救小组救治的成年患者(年龄>14岁)均纳入本研究。
从以下方面评估心肺复苏(CPR)情况:反应时间、初始呈现的心律、首次除颤时间、CPR持续时间及结果(自主循环恢复(ROSC)、出院时的格拉斯哥预后评分(GOS))。
采用t检验和方差分析对年龄、GOS和平均反应时间进行分析。应用逻辑回归确定各因素在确定死亡率方面的显著性。
在我们研究纳入的127例患者中,44%实现了ROSC。心脏停搏/无脉电活动(PEA)是最常见的初始呈现心律(87.5%)。7.1%的患者存活至出院,其中只有3.9%的患者有良好的神经功能预后。回归分析和生存分析表明,CPR期间实现ROSC、无合并症以及蓝色急救小组较短的反应时间是良好预后的预测因素。
我们发现院内心脏骤停后CPR的结果较差。这主要归因于大多数情况下初始呈现的心律为心脏停搏/PEA以及反应时间延迟。