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院前声门上气道与心脏骤停患者良好的神经学预后相关,尤其是那些接受了长时间心肺复苏的患者。

Prehospital Supraglottic Airway Was Associated With Good Neurologic Outcome in Cardiac Arrest Victims Especially Those Who Received Prolonged Cardiopulmonary Resuscitation.

作者信息

Park Min Ji, Kwon Woon Yong, Kim Kyuseok, Suh Gil Joon, Shin Jonghwan, Jo You Hwan, Kim Kyung Su, Lee Hui Jai, Kim Joonghee, Lee Se Jong, Kim Jeong Yeon, Cho Jun Hwi

机构信息

Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do.

Department of Emergency Medicine, Seoul National University College of Medicine, Seoul.

出版信息

Acad Emerg Med. 2017 Dec;24(12):1464-1473. doi: 10.1111/acem.13309. Epub 2017 Nov 8.

Abstract

OBJECTIVES

We performed this study to investigate the association of prehospital supraglottic airway (SGA) on neurologic outcome in cardiac arrest victims with adjustment of postresuscitation variables as well as prehospital and resuscitation variables.

METHODS

This study was a retrospective study based on a multicenter prospective cohort registry from December 2013 to April 2016. According to the 28-day cerebral performance categories (CPCs) scale, patients were divided into the good-outcome group (CPC 1-2) and the poor-outcome group (CPC 3-5). We compared the two groups with respect to demographic variables, prehospital and in-hospital resuscitation variables, and postresuscitation variables.

RESULTS

A total of 869 cardiac arrest victims who received in-progress cardiopulmonary resuscitation (CPR) were delivered to the emergency department of three hospitals, and 310 patients were admitted to the intensive care unit. The use of a prehospital SGA was independently associated with 28-day good neurologic outcome (odds ratio [OR] = 7.88; 95% confidence interval [CI] = 1.33-46.53; p = 0.023] when postresuscitation variables were adjusted, although there were no significant association with the acquisition of sustained return of spontaneous circulation (OR = 0.992; 95% CI = 0.591-1.666; p = 0.976). Furthermore, a prehospital SGA was significantly associated with good neurologic outcome, especially in patients who received prolonged CPR (low flow time > 15 minutes; OR = 3.41; 95% CI = 1.23-9.45; p = 0.018) rather than in patients with nonprolonged CPR (OR = 4.50; 95% CI = 0.75-27.13; p = 0.101).

CONCLUSIONS

When postresuscitation variables were adjusted, the prehospital SGA was independently associated with 28-day good neurologic outcome in cardiac arrest victims.

摘要

目的

我们开展本研究以调查院外声门上气道(SGA)与心脏骤停患者神经功能结局之间的关联,并对复苏后变量以及院前和复苏变量进行校正。

方法

本研究是一项基于2013年12月至2016年4月多中心前瞻性队列登记的回顾性研究。根据28天脑功能分类(CPC)量表,将患者分为良好结局组(CPC 1 - 2)和不良结局组(CPC 3 - 5)。我们比较了两组在人口统计学变量、院前和院内复苏变量以及复苏后变量方面的数据。

结果

共有869例正在接受心肺复苏(CPR)的心脏骤停患者被送至三家医院的急诊科,310例患者被收入重症监护病房。在校正复苏后变量后,院外使用SGA与28天良好神经功能结局独立相关(优势比[OR]=7.88;95%置信区间[CI]=1.33 - 46.53;p = 0.023),尽管与获得持续自主循环无显著关联(OR = 0.992;95% CI = 0.591 - 1.666;p = 0.976)。此外,院外SGA与良好神经功能结局显著相关,尤其是在接受长时间CPR(低血流时间>15分钟;OR = 3.41;95% CI = 1.23 - 9.45;p = 0.018)的患者中,而非在未接受长时间CPR的患者中(OR = 4.50;95% CI = 0.75 - 27.13;p = 0.101)。

结论

在校正复苏后变量后,院外SGA与心脏骤停患者28天良好神经功能结局独立相关。

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