Cartledge Susie, Bray Janet E, Leary Marion, Stub Dion, Finn Judith
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Alfred Hospital, Melbourne, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Alfred Hospital, Melbourne, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia.
Resuscitation. 2016 Aug;105:70-8. doi: 10.1016/j.resuscitation.2016.04.028. Epub 2016 May 18.
Targeting basic life support (BLS) training to bystanders who are most likely to witness an out of hospital cardiac arrest (OHCA) is an important public health intervention. We performed a systematic review examining the evidence of the effectiveness of providing BLS training to family members of high-risk cardiac patients.
A search of Ovid MEDLINE, CINAL, EMBASE, Informit, Cochrane Library, Web of Science, Scopus, ERIC and ProQuest Dissertations and Theses Global was conducted. We included all studies training adult family members of high-risk cardiac patients regardless of methods used for cardiopulmonary resuscitation (CPR) or BLS training. Two reviewers independently extracted data and evaluated the quality of evidence using GRADE (Grades of Recommendation, Assessment, Development and Evaluation).
We included 26 of the 1172 studies identified. The majority of studies were non-randomised controlled trials (n=18), of very low to moderate quality. Currently, there is insufficient evidence to indicate a benefit of this intervention for patients; largely because of low numbers of OHCA events and high loss to follow-up. However, the majority of trained individuals were able to competently perform BLS skills, reported a willingness to use these skills and experienced lower anxiety.
Whilst there is no current evidence for improvement in patient outcomes from targeted BLS training for family members, this group are willing and capable to learn these skills. Future research may need to examine longer periods of follow-up using alternate methods (e.g. cardiac arrest registries), and examine the effectiveness of training in the modern era.
针对最有可能目睹院外心脏骤停（OHCA）的旁观者开展基础生命支持（BLS）培训是一项重要的公共卫生干预措施。我们进行了一项系统评价，以考察对高危心脏病患者家属进行BLS培训有效性的证据。
检索了Ovid MEDLINE、CINAL、EMBASE、Informit、Cochrane图书馆、科学网、Scopus、ERIC以及ProQuest学位论文与全球博硕士论文数据库。我们纳入了所有培训高危心脏病患者成年家属的研究，无论其用于心肺复苏（CPR）或BLS培训的方法如何。两名评价员独立提取数据，并使用GRADE（推荐分级、评估、制定与评价）对证据质量进行评估。
我们纳入了所识别的1172项研究中的26项。大多数研究为非随机对照试验（n = 18），质量极低至中等。目前，尚无足够证据表明该干预措施对患者有益；主要原因是OHCA事件数量少且失访率高。然而，大多数接受培训的个体能够熟练掌握BLS技能，报告愿意使用这些技能，且焦虑程度较低。
虽然目前尚无证据表明针对家属的目标性BLS培训能改善患者结局，但这一群体愿意且有能力学习这些技能。未来的研究可能需要使用替代方法（如心脏骤停登记处）进行更长时间的随访，并考察现代时代培训的有效性。
