Nongchang Phichet, Wong Wongsa Laohasiri, Pitaksanurat Somsak, Amchai Pairoj Boonsirik
PhD Scholar, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Associate Professor, Faculty of Public Health and Research and Training Center for Enhancing Quality of Life for Working Age People, Khon Kaen University, Khon Kaen, Thailand.
J Clin Diagn Res. 2017 Sep;11(9):OC29-OC32. doi: 10.7860/JCDR/2017/29603.10656. Epub 2017 Sep 1.
Out of Hospital Cardiac Arrest (OHCA) is a leading cause of death worldwide. The Emergency Medical Service (EMS) provides early care to critical OHCA patients. Pre hospital intervention has been improving OHCA survival rate, however it is still unclear for the recommendation of routine infusion of Intravenous (IV) fluids during cardiac arrest resuscitation.
This study aimed to determine whether IV fluid administration was associated with increasing survival of resuscitated OHCA patients and to assess the survival rate of resuscitated OHCA patients.
This cross-sectional analytical study was conducted among 33,006 resuscitated OHCA patients who received emergency medical service in Thailand. Data set from the EMS Registry of the OHCA patients who received Advanced Life Support (ALS) and Cardiopulmonary Resuscitation (CPR) during January 2011 to December 2015 was enrolled as per inclusion criteria. Data were analysed by using both descriptive statistic and multiple logistic regression.
The result indicated that 27,270 OHCA patients (82.62%:95%CI=82.121-83.030%) survived until they reached hospital. In addition, after adjusting for effect modifiers and covariates, it was found that adult (≥18 years) with IV fluid administration were more likely to survive (adjusted OR=4.389; 95% CI: 3.911-4.744) when compared to children (<18 years) with IV fluid administration (adjusted OR =2.952; 95% CI: 2.040-4.273). Other factors associated with OHCA patients' survival were female gender (adjusted OR =1.151; 95% CI: 1.067-1.241), response time per minutes (adjusted OR =0.993; 95% CI: 0.989-0.997), scene time per minutes (adjusted OR=0.948; 95% CI: 0.944-0.952) and transport time per minutes (adjusted OR=0.973, 95%CI: 0.968-0.978).
This study revealed that IV fluid administration was significantly associated with survival of OHCA patients while controlled other covariates including female gender, response time, scene time and transport time. Therefore, it is recommended that the IV fluid administration should be medicated for resuscitated OHCA patients.
院外心脏骤停（OHCA）是全球主要的死亡原因。紧急医疗服务（EMS）为重症OHCA患者提供早期护理。院前干预一直在提高OHCA的生存率，然而，在心脏骤停复苏期间常规输注静脉（IV）液体的建议仍不明确。
本研究旨在确定静脉输液是否与复苏后的OHCA患者生存率增加相关，并评估复苏后的OHCA患者的生存率。
本横断面分析研究在泰国接受紧急医疗服务的33006例复苏后的OHCA患者中进行。根据纳入标准，纳入了2011年1月至2015年12月期间接受高级生命支持（ALS）和心肺复苏（CPR）的OHCA患者的EMS登记数据集。使用描述性统计和多元逻辑回归分析数据。
结果表明，27270例OHCA患者（82.62%：95%CI=82.121-83.030%）存活至入院。此外，在调整了效应修饰因素和协变量后，发现接受静脉输液的成年人（≥18岁）比接受静脉输液的儿童（<18岁）更有可能存活（调整后的OR=4.389；95%CI：3.911-4.744）（调整后的OR=2.952；95%CI：2.040-4.273）。与OHCA患者生存相关的其他因素包括女性（调整后的OR=1.151；95%CI：1.067-1.241）、每分钟反应时间（调整后的OR=0.993；95%CI：0.989-0.997）、每分钟现场时间（调整后的OR=0.948；95%CI：0.944-0.952）和每分钟转运时间（调整后的OR=0.973，95%CI：0.968-0.978）。
本研究表明，在控制了包括女性、反应时间、现场时间和转运时间等其他协变量的情况下，静脉输液与OHCA患者的生存显著相关。因此，建议对复苏后的OHCA患者进行静脉输液治疗。
