Lee Young Hwan, Lee Kui Ja, Min Yong Hun, Ahn Hee Cheol, Sohn You Dong, Lee Won Woong, Oh Young Taeck, Cho Gyu Chong, Seo Jeong Yeol, Shin Dong Hyuk, Park Sang O, Park Seung Min
Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea; Department of emergency medicine, College of Medicine, Kangwon National University, Chuncheon, Gangwon 200-701, Republic of Korea.
Department of Emergency Medical Technology, Seojeong College, Yangju, Republic of Korea.
Resuscitation. 2016 Oct;107:150-5. doi: 10.1016/j.resuscitation.2016.07.243. Epub 2016 Aug 11.
This study aimed to evaluate the effects of esmolol treatment for patients with refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest (OHCA).
This single-centre retrospective pre-post study evaluated patients who were treated between January 2012 and December 2015. Some patients had received esmolol (loading dose: 500μg/kg, infusion: 0-100μg/kg/min) for RVF (≥3 defibrillation attempts), after obtaining consent from the patient's guardian.
Twenty-five patients did not receive esmolol (the control group), and 16 patients received esmolol. Sustained return of spontaneous circulation (ROSC) was significantly more common in the esmolol group, compared to the control group (56% vs. 16%, p=0.007). Survival and good neurological outcomes at 30 days, 3 months and at 6 months were >2-fold better in the esmolol group, compared to the control group, although these increases were not statistically significant.
The findings of our study suggest that administration of esmolol may increase the rate of sustained ROSC and ICU survival among patients with RVF in OHCA. Further larger-scale, prospective studies are necessary to determine the effect of esmolol for RVF in OHCA.
本研究旨在评估艾司洛尔治疗院外心脏骤停（OHCA）中难治性室颤（RVF）患者的效果。
这项单中心回顾性前后对照研究评估了2012年1月至2015年12月期间接受治疗的患者。部分患者在获得患者监护人同意后，因室颤（≥3次除颤尝试）接受了艾司洛尔治疗（负荷剂量：500μg/kg，输注速度：0 - 100μg/kg/min）。
25例患者未接受艾司洛尔治疗（对照组），16例患者接受了艾司洛尔治疗。与对照组相比，艾司洛尔组自主循环恢复（ROSC）的持续率显著更高（56%对16%，p = 0.007）。尽管这些增加无统计学意义，但艾司洛尔组在30天、3个月和6个月时的生存率及良好神经功能结局比对照组高出2倍多。
我们的研究结果表明，在OHCA中，给予艾司洛尔可能会提高RVF患者的持续ROSC率和重症监护病房生存率。需要进一步开展更大规模的前瞻性研究来确定艾司洛尔对OHCA中RVF的疗效。
