Burstein Barry, Jayaraman Dev, Husa Regina
a Division of Cardiology , McGill University , Montreal , Quebec , Canada.
b Department of Critical Care , McGill University Health Center and Jewish General Hospital, McGill University , Montreal , Quebec , Canada.
Acute Card Care. 2016 Jun;18(2):35-39. doi: 10.1080/17482941.2017.1293831. Epub 2017 Mar 22.
Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest. The significance of the post-arrest echocardiogram, specifically the left ventricular ejection fraction (LVEF) is unknown.
We performed a retrospective cohort study of patients who suffered from cardiac arrest between 1 January 2009 and 31 December 2013. We included all patients who achieved return of spontaneous circulation (ROSC), and were admitted to the intensive care unit (ICU) or coronary care unit (CCU) of a tertiary care academic center. Patients who underwent echocardiography within 24 h of cardiac arrest were included for analysis. The primary outcome was survival.
We identified 151 patients who achieved ROSC of which 97 underwent post-arrest echocardiogram within 24 h. 70.8% were males and the mean age was 67.8 years (SD: 15.9). The mean LVEF at 24 h was 35.7 (SD: 17.8). LVEF > 40% was not a predictor of survival at 30 days or hospital discharge. The only significant predictors on multivariate analyses were age, presence of shockable rhythm and time to ROSC.
Although echocardiograms are frequently ordered, LVEF greater than 40% in patients who are resuscitated after a cardiac arrest is not a predictor of survival.
心肺复苏和早期除颤已被证明可改善心脏骤停的预后。心脏骤停后超声心动图的意义，特别是左心室射血分数（LVEF）尚不清楚。
我们对2009年1月1日至2013年12月31日期间发生心脏骤停的患者进行了一项回顾性队列研究。我们纳入了所有实现自主循环恢复（ROSC）并入住三级医疗学术中心重症监护病房（ICU）或冠心病监护病房（CCU）的患者。纳入心脏骤停后24小时内接受超声心动图检查的患者进行分析。主要结局是生存。
我们确定了151例实现ROSC的患者，其中97例在24小时内接受了心脏骤停后超声心动图检查。男性占70.8%，平均年龄为67.8岁（标准差：15.9）。24小时时的平均LVEF为35.7（标准差：17.8）。LVEF>40%不是30天或出院时生存的预测指标。多变量分析中唯一显著的预测指标是年龄、可电击心律的存在和至ROSC的时间。
尽管经常开具超声心动图检查，但心脏骤停后复苏患者的LVEF大于40%不是生存的预测指标。
