Institute of Mountain Emergency Medicine, EURAC Research, Viale Druso 1, 39100, Bolzano, Italy.
Department of Anaesthesiology, University Hospital, LMU Munich, 80337, Munich, Germany.
Scand J Trauma Resusc Emerg Med. 2018 Apr 28;26(1):36. doi: 10.1186/s13049-018-0503-4.
In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.
在这项前瞻性观察研究中，我们描述了在意大利南蒂罗尔的配备医师的直升机紧急医疗服务（HEMS）中实施机械心肺复苏（CPR）设备（LUCAS 2；Physio Control，雷德蒙德，华盛顿州，美国）后，接受机械 CPR 的院外心脏骤停（OHCA）病例的发生率和特征。在研究期间（2013 年 6 月至 2016 年 4 月），调度中心登记了 525 例 OHCA 病例，其中 271 例（51.6%）由 HEMS 协助。在所有接受 HEMS 协助的 OHCA 患者中，LUCAS 2 应用于 18 例（6.6%）；10 例仅在现场接受 LUCAS 2 治疗，8 例在持续 CPR 下转运至医院。18 例患者中有 2 例（11.1%）长期存活并完全恢复神经功能。在 8 例持续 CPR 转运至医院的患者中，在急诊室停止 CPR 而未进一步干预。回顾性地，对所有接受 HEMS 协助的 OHCA 病例进行了筛选，以确定符合延长 CPR 指征的标准。符合这些标准的患者有 13 例，但只有 2 例被转运至医院。基于这些结果，我们为没有 ECLS 能力的医院的难治性 OHCA HEMS 协助患者提出了一个标准操作程序。
