Keck School of Medicine of the University of Southern California, Division of Trauma Anesthesiology, Los Angeles, CaliforniaUSA.
Indiana University School of Public Health-Bloomington, Bloomington, IndianaUSA.
Prehosp Disaster Med. 2020 Apr;35(2):141-147. doi: 10.1017/S1049023X20000060. Epub 2020 Jan 24.
The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.
HYPOTHESIS/PROBLEM: The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.
The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable survival, as defined by cerebral performance category (CPC).
Neurologically favorable survival was statistically significantly associated with CV-CPR in pediatric patients aged five to 15 years (aOR = 2.68; 95% CI, 1.10-6.77; P = .03), as well as all age group survival to hospital discharge (aOR = 1.54; 95% CI, 1.01-2.36; P = .046). There was a trend with CV-CPR toward neurologically favorable survival in all age groups (aOR = 1.35; 95% CI, 0.86-2.10; P = .19) and all age group survival to hospital admission (aOR = 1.29; 95% CI, 0.91-1.84; P = .157).
In cases of cardiac arrest following drowning, bystander CV-CPR was statistically significantly associated with neurologically favorable survival in children aged five to 15 years and survival to hospital discharge.
仅胸外按压心肺复苏(CO-CPR)的概念源自一种观点,即急救人员在紧急情况下可能不太可能进行口对口通气。本研究旨在描述在溺水后心脏骤停期间旁观者进行心肺复苏(CV-CPR)中胸外按压和通气的效果。
假设/问题:本研究旨在检验以下假设,即在溺水后心脏骤停的情况下,与仅进行胸外按压的 CPR 相比,由旁观者进行的心肺复苏(CPR)利用按压和通气可提高存活率。
通过心脏骤停注册增强生存(CARES)查询了 2013 年 1 月 1 日至 2017 年 12 月 31 日期间溺水后发生心脏骤停的患者的数据,其中包括提供的旁观者 CPR 类型(即 CV-CPR 和 CO-CPR)。主要观察结果是神经功能良好的存活,定义为脑功能分类(CPC)。
在 5 至 15 岁的儿科患者中,CV-CPR 与神经功能良好的存活在统计学上显著相关(优势比[OR] = 2.68;95%置信区间[CI],1.10-6.77;P =.03),以及所有年龄段患者的存活率至医院出院(OR = 1.54;95%CI,1.01-2.36;P =.046)。CV-CPR 有向所有年龄段的神经功能良好的存活的趋势(OR = 1.35;95%CI,0.86-2.10;P =.19)和所有年龄段患者的存活率至医院入院(OR = 1.29;95%CI,0.91-1.84;P =.157)。
在溺水后心脏骤停的情况下,与仅进行胸外按压的 CPR 相比,5 至 15 岁儿童的旁观者 CV-CPR 与神经功能良好的存活以及存活率至医院出院在统计学上显著相关。