考克兰系统评价对心脏骤停管理有何看法?

What do Cochrane systematic reviews say about cardiac arrest management?

作者信息

Pacheco Rafael Leite, Trevizo Juliana, Souza Caio Augusto de, Alves Gabriel, Sakaya Bruno, Thiago Luciana, Góis Aécio Flávio Teixeira de, Riera Rachel

机构信息

Cochrane Brazil, São Paulo, SP, Brazil.

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

出版信息

Sao Paulo Med J. 2018 Mar;136(2):170-176. doi: 10.1590/1516-3180.2018.0083230318.

Abstract

CONTEXT AND OBJECTIVE

Cardiac arrest is associated with high morbidity and mortality and imposes a significant burden on the healthcare system. Management of cardiac arrest patients is complex and involves approaches with multiple interventions. Here, we aimed to summarize the available evidence regarding the interventions used in cardiac arrest cases.

DESIGN AND SETTING

Review of systematic reviews (SRs), conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo.

METHODS

A systematic search was conducted to identify all Cochrane SRs that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors.

RESULTS

We included nine Cochrane SRs assessing compression techniques or devices (three SRs), defibrillation (two SRs) and other interventions (two SRs on hypothermia interventions, one on airway management and one on pharmacological intervention). The reviews included found qualities of evidence ranging from unknown to high, regarding the benefits of these interventions.

CONCLUSION

This review included nine Cochrane systematic reviews that provided a diverse range of qualities of evidence (unknown to high) regarding interventions that are used in management of cardiac arrest. High-quality evidence was found by two systematic reviews as follows: (a) increased survival until hospital discharge with continuous compression, compared with interrupted chest compression, both administered by an untrained person and (b) no difference regarding the return of spontaneous circulation, comparing aminophylline and placebo, for bradyasystolic patients under cardiac arrest. Further studies are needed in order to reach solid conclusions.

摘要

背景与目的

心脏骤停与高发病率和死亡率相关,给医疗系统带来了沉重负担。心脏骤停患者的管理复杂,涉及多种干预措施。在此,我们旨在总结关于心脏骤停病例中所用干预措施的现有证据。

设计与研究地点

在圣保罗联邦大学保罗医科大学循证医学学科进行的系统评价(SR)综述。

方法

进行系统检索,以识别所有符合纳入标准的Cochrane系统评价。由两位作者筛选标题和摘要。

结果

我们纳入了9篇Cochrane系统评价,评估按压技术或设备(3篇系统评价)、除颤(2篇系统评价)以及其他干预措施(2篇关于低温干预、1篇关于气道管理和1篇关于药物干预的系统评价)。所纳入的综述发现,这些干预措施的益处的证据质量从未知到高不等。

结论

本综述纳入了9篇Cochrane系统评价,这些评价提供了关于心脏骤停管理中所用干预措施的各种证据质量(从未知到高)。两项系统评价发现了高质量证据如下:(a)与由未经培训的人员进行的间断胸外按压相比,持续按压可提高出院存活率;(b)对于心脏骤停的缓慢性心搏停止患者,氨茶碱和安慰剂在自主循环恢复方面无差异。需要进一步研究以得出确凿结论。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索