Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Department of Emergency Medicine, Myoungji Hospital, Goyang-si, Republic of Korea.
Am J Emerg Med. 2018 Feb;36(2):248-252. doi: 10.1016/j.ajem.2017.07.089. Epub 2017 Jul 30.
The objective of this systematic review and meta-analysis was to determine the effects of team cardiopulmonary resuscitation (CPR) on outcomes of patients with out-of-hospital cardiac arrest (OHCA).
A systematic literature review was performed using PubMed, EMBASE, and the Cochrane database to identify relevant articles for this meta-analysis. All studies that described the implementation of team CPR performed by emergency medical services for OHCA patients with presumed cardiac etiology were included in this study. Outcomes included return of spontaneous circulation (ROSC), survival to hospital discharge, and good neurological recovery.
A total of 2504 studies were reviewed. After excluding studies according to exclusion criteria, 4 studies with 15,455 OHCA patients were included in this study. The odds of survival and neurologic recovery for patients who received team CPR were higher than those for patients who did not (survival odds ratio [OR]: 1.68; 95% confidence interval [CI]: 1.48-1.91; neurologic recovery OR: 1.52; 95% CI: 1.31-1.77). There was no significant difference in the odds of ROSC between the two patient groups (OR: 1.59; 95% CI: 0.76-3.33).
In this meta-analysis, team CPR improved the outcomes of OHCA patients, consistently increasing their odds of survival to discharge and neurologic recovery.
本系统评价和荟萃分析的目的是确定团队心肺复苏术(CPR)对院外心脏骤停(OHCA)患者结局的影响。
使用 PubMed、EMBASE 和 Cochrane 数据库进行系统文献检索,以确定本荟萃分析的相关文章。本研究纳入了所有描述急救医疗服务团队对疑似心源性 OHCA 患者实施团队 CPR 的研究。结局包括自主循环恢复(ROSC)、存活至出院和良好神经恢复。
共审查了 2504 项研究。根据排除标准排除研究后,本研究纳入了 4 项研究共 15455 例 OHCA 患者。接受团队 CPR 的患者的存活和神经恢复几率高于未接受团队 CPR 的患者(存活优势比 [OR]:1.68;95%置信区间 [CI]:1.48-1.91;神经恢复 OR:1.52;95% CI:1.31-1.77)。两组患者 ROSC 的几率无显著差异(OR:1.59;95% CI:0.76-3.33)。
在本荟萃分析中,团队 CPR 改善了 OHCA 患者的结局,一致提高了患者存活至出院和神经恢复的几率。