Kurt Funda, Kendirli Tanıl, Gündüz Ramiz Coskun, Kesici Selman, Akça Halise, Şahin Şanlıay, Kalkan Gökhan, Derbent Murat, Tuygun Nilden, Ödek Çağlar, Gültekingil Ayşe, Oğuz Sinan, Polat Emine, Derinöz Okşan, Tekin Deniz, Tekşam Özlem, Bayrakcı Benan, Suskan Emine
Division of Pediatric Emergency Medicine, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey.
Division of Pediatric Intensive Care Unit, Department of Pediatrics, Ankara University Faculty of Medicine.
Turk J Pediatr. 2018;60(5):488-496. doi: 10.24953/turkjped.2018.05.004.
Kurt F, Kendirli T, Gündüz RC, Kesici S, Akça H, Şahin Ş, Kalkan G, Derbent M, Tuygun N, Ödek Ç, Gültekin-Keser A, Oğuz S, Polat E, Derinöz O, Tekin D, Tekşam Ö, Bayrakcı B, Suskan E. Outcome of out-of-hospital cardiopulmonary arrest in children: A multicenter cohort study. Turk J Pediatr 2018; 60: 488-496. The aim of this study was to evaluate the demographic characteristics of children who experienced out-of-hospital cardiopulmonary arrest (CPA), and to assess the impact of the bystander cardiopulmonary resuscitation (CPR) on the survival rate of witnessed arrests and the effects of the arrest and CPR durations on the neurological outcomes. This multicenter, retrospective study included a total of 182 patients who underwent CPR for out-of-hospital CPA between January 2008 and December 2012 at six centers in Ankara, Turkey. The median [interquartile range (IQR)] age was 22 (5-54) months; 60.4% of the patients were males, and 44% were younger than one year of age. The witnessed arrest rate was 75.8% (138/182) and the rate of bystander CPR was 13.9% (13/93). In these patients the rate of the return of spontaneous circulation (ROSC) was higher (76.9%). Following resuscitation in the patients for whom the spontaneous circulation was able to be returned, the median (IQR) duration of arrest was 5 (1- 15) min, while it was 15 (5-40) min for the remaining patients (p < 0.001). The ROSC rate was 94.9% in patients who underwent CPR for less than 20 min and 22% in patients requiring CPR longer than 20 min (p < 0.001). Survival to hospital discharge was 14.3%. Of these patients, 57.7% experienced neurological disability. The short duration of an arrest and the presence of CPR are both critical for survival. We suggest that a witness to the CPA, performing early and efficient CPR, yields better results.
库尔特·F、肯迪尔利·T、居恩杜兹·R·C、凯西奇·S、阿克恰·H、萨欣·Ş、卡尔坎·G、德尔本特·M、图伊贡·N、奥德克·Ç、居尔泰金 - 凯泽尔·A、奥古兹·S、波拉特·E、德林öz·O、特金·D、特克萨姆·Ö、巴伊拉克cı·B、苏斯坎·E。儿童院外心肺复苏的结局：一项多中心队列研究。《土耳其儿科学杂志》2018年；60: 488 - 496。本研究的目的是评估经历院外心肺骤停（CPA）的儿童的人口统计学特征，评估旁观者心肺复苏（CPR）对目击骤停存活率的影响以及骤停和CPR持续时间对神经学结局的影响。这项多中心回顾性研究共纳入了2008年1月至2012年12月期间在土耳其安卡拉的六个中心接受院外CPA心肺复苏的182例患者。年龄中位数[四分位间距（IQR）]为22（5 - 54）个月；60.4%的患者为男性，44%的患者年龄小于1岁。目击骤停率为75.8%（138/182），旁观者CPR率为13.9%（13/93）。这些患者的自主循环恢复（ROSC）率较高（76.9%）。在能够恢复自主循环的患者复苏后，骤停的中位数（IQR）持续时间为5（1 - 15）分钟，而其余患者为15（5 - 40）分钟（p < 0.001）。CPR时间小于20分钟的患者ROSC率为94.9%，CPR时间超过20分钟的患者ROSC率为22%（p < 0.001）。出院存活率为14.3%。在这些患者中，57.7%有神经功能残疾。骤停时间短和进行CPR对存活都至关重要。我们建议CPA的目击者尽早进行有效的CPR会产生更好的结果。
