心脏骤停成人患者复苏后及复苏中高氧与死亡率的关系：系统评价和荟萃分析。
Association between intra- and post-arrest hyperoxia on mortality in adults with cardiac arrest: A systematic review and meta-analysis.
机构信息
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
出版信息
Resuscitation. 2018 Jun;127:83-88. doi: 10.1016/j.resuscitation.2018.04.008. Epub 2018 Apr 10.
OBJECTIVES
The association between intra-arrest and post-arrest hyperoxia and mortality in adults with cardiac arrest (CA) is widely debated. We therefore conducted a systematic review and meta-analysis to investigate the association between intra-arrest and post-arrest hyperoxia and mortality in adults with CA.
METHODS
We systematically searched MEDLINE and Cochrane databases to identify observational studies from January 2008 to December 2017 investigating the relationship between hyperoxia (either intra-arrest or post-arrest) and mortality in adults with CA.
RESULTS
We included 16 observational studies with a total of 40,573 adult patients. Six studies included patients only with out-of-hospital CA (OHCA), 2 studies included patients only with in-hospital CA (IHCA), and 8 studies included patients with both OHCA and IHCA. Two studies assessed intra-arrest hyperoxia while 14 studies examined post-arrest hyperoxia. Of the 10 studies included for quantitative analysis, intra-arrest hyperoxia was associated with a significantly lower mortality rate [odds ratio (OR) 0.25, 95% confidence interval (CI) 0.12-0.53, p < 0.001] while post-arrest hyperoxia was associated with higher mortality (OR 1.34, 95%CI 1.08-1.67, p = 0.008).
CONCLUSIONS
In adults with CA, intra-arrest hyperoxia is associated with lower mortality while post-arrest hyperoxia is associated with higher mortality.
目的
在心脏骤停（CA）的成年人中，停搏期和停搏后高氧血症与死亡率之间的关联存在广泛争议。因此，我们进行了系统评价和荟萃分析，以调查 CA 成人停搏期和停搏后高氧血症与死亡率之间的关联。
方法
我们系统地检索了 MEDLINE 和 Cochrane 数据库，以确定 2008 年 1 月至 2017 年 12 月期间调查高氧血症（停搏期或停搏后）与 CA 成年人死亡率之间关系的观察性研究。
结果
我们纳入了 16 项观察性研究，共有 40573 名成年患者。6 项研究仅包括院外 CA（OHCA）患者，2 项研究仅包括院内 CA（IHCA）患者，8 项研究包括 OHCA 和 IHCA 患者。2 项研究评估了停搏期高氧血症，而 14 项研究检查了停搏后高氧血症。在纳入进行定量分析的 10 项研究中，停搏期高氧血症与死亡率显著降低相关[比值比（OR）0.25，95%置信区间（CI）0.12-0.53，p<0.001]，而停搏后高氧血症与死亡率升高相关（OR 1.34，95%CI 1.08-1.67，p=0.008）。
结论
在 CA 成人中，停搏期高氧血症与较低的死亡率相关，而停搏后高氧血症与较高的死亡率相关。
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