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采用Utstein模式对成人院内心脏骤停进行心肺复苏。

Cardiopulmonary resuscitation of adults with in-hospital cardiac arrest using the Utstein style.

作者信息

Silva Rose Mary Ferreira Lisboa da, Silva Bruna Adriene Gomes de Lima E, Silva Fábio Junior Modesto E, Amaral Carlos Faria Santos

机构信息

Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.

出版信息

Rev Bras Ter Intensiva. 2016 Oct-Dec;28(4):427-435. doi: 10.5935/0103-507X.20160076.

Abstract

OBJECTIVE

: The objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style.

METHODS

: This study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year.

RESULTS

: The study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59.0 years. The episodes occurred during the daytime in 64.6% of cases. Asystole/bradyarrhythmia was the most frequent initial rhythm (42.7%). Most patients who exhibited a spontaneous return of circulation experienced recurrent cardiac arrest, especially within the first 24 hours (61.4%). The mean time elapsed between hospital admission and the occurrence of cardiac arrest was 10.3 days, the mean time between cardiac arrest and cardiopulmonary resuscitation was 0.68 min, the mean time between cardiac arrest and defibrillation was 7.1 min, and the mean duration of cardiopulmonary resuscitation was 16.3 min. Associations between gender and the duration of cardiopulmonary resuscitation (19.2 min in women versus 13.5 min in men, p = 0.02), the duration of cardiopulmonary resuscitation and the return of spontaneous circulation (10.8 min versus 30.7 min, p < 0.001) and heart disease and age (60.6 years versus 53.6, p < 0.001) were identified. The immediate survival rates after cardiac arrest, until hospital discharge and 6 months after discharge were 71%, 9% and 6%, respectively.

CONCLUSIONS

: The main initial rhythm detected was asystole/bradyarrhythmia; the interval between cardiac arrest and cardiopulmonary resuscitation was short, but defibrillation was delayed. Women received cardiopulmonary resuscitation for longer periods than men. The in-hospital survival rate was low.

摘要

目的

本研究的目的是采用Utstein模式分析院内心脏骤停患者的临床特征。

方法

本研究是一项对重症监护病房中接受治疗的心脏骤停患者进行的为期1年的观察性、前瞻性纵向研究。

结果

该研究纳入了89例接受心肺复苏操作的患者。队列中男性占51.6%,平均年龄59.0岁。64.6%的病例发作发生在白天。心搏停止/缓慢性心律失常是最常见的初始心律(42.7%)。大多数出现自主循环恢复的患者经历了反复心脏骤停,尤其是在最初24小时内(61.4%)。入院至心脏骤停发生的平均时间为10.3天,心脏骤停至心肺复苏的平均时间为0.68分钟,心脏骤停至除颤的平均时间为7.1分钟,心肺复苏的平均持续时间为16.3分钟。确定了性别与心肺复苏持续时间(女性为19.2分钟,男性为13.5分钟,p = 0.02)、心肺复苏持续时间与自主循环恢复(10.8分钟对30.7分钟,p < 0.001)以及心脏病与年龄(60.6岁对53.6岁,p < 费0.001)之间的关联。心脏骤停后直至出院和出院后6个月的即时生存率分别为71%、9%和6%。

结论

检测到的主要初始心律是心搏停止/缓慢性心律失常;心脏骤停与心肺复苏之间的间隔时间较短,但除颤延迟。女性接受心肺复苏的时间比男性长。院内存活率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28a/5225918/f2f639d1f488/rbti-28-04-0427-gf01.jpg

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