Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Beijing, China; Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Resuscitation. 2020 Jun;151:18-23. doi: 10.1016/j.resuscitation.2020.04.005. Epub 2020 Apr 10.
To describe the characteristics and outcomes of patients with severe COVID-19 and in-hospital cardiac arrest (IHCA) in Wuhan, China.
The outcomes of patients with severe COVID-19 pneumonia after IHCA over a 40-day period were retrospectively evaluated. Between January 15 and February 25, 2020, data for all cardiopulmonary resuscitation (CPR) attempts for IHCA that occurred in a tertiary teaching hospital in Wuhan, China were collected according to the Utstein style. The primary outcome was restoration of spontaneous circulation (ROSC), and the secondary outcomes were 30-day survival, and neurological outcome.
Data from 136 patients showed 119 (87.5%) patients had a respiratory cause for their cardiac arrest, and 113 (83.1%) were resuscitated in a general ward. The initial rhythm was asystole in 89.7%, pulseless electrical activity (PEA) in 4.4%, and shockable in 5.9%. Most patients with IHCA were monitored (93.4%) and in most resuscitation (89%) was initiated <1 min. The average length of hospital stay was 7 days and the time from illness onset to hospital admission was 10 days. The most frequent comorbidity was hypertension (30.2%), and the most frequent symptom was shortness of breath (75%). Of the patients receiving CPR, ROSC was achieved in 18 (13.2%) patients, 4 (2.9%) patients survived for at least 30 days, and one patient achieved a favourable neurological outcome at 30 days. Cardiac arrest location and initial rhythm were associated with better outcomes.
Survival of patients with severe COVID-19 pneumonia who had an in-hospital cardiac arrest was poor in Wuhan.
描述中国武汉严重 COVID-19 患者和院内心搏骤停（IHCA）的特征和结局。
回顾性评估了在 COVID-19 肺炎严重程度患者中发生 IHCA 后 40 天内的结局。2020 年 1 月 15 日至 2 月 25 日，收集了中国武汉一家三级教学医院所有 IHCA 心肺复苏（CPR）尝试的数据，符合 Utstein 风格。主要结局是自主循环恢复（ROSC），次要结局是 30 天生存率和神经结局。
来自 136 名患者的数据显示，119 名（87.5%）患者的心脏骤停原因是呼吸系统，113 名（83.1%）在普通病房复苏。初始节律为心搏停止 89.7%，无脉电活动（PEA）4.4%，可除颤 5.9%。大多数 IHCA 患者均接受监测（93.4%），大多数复苏（89%）在<1 分钟内开始。平均住院时间为 7 天，从发病到住院的时间为 10 天。最常见的合并症是高血压（30.2%），最常见的症状是呼吸急促（75%）。接受 CPR 的患者中，18 名（13.2%）患者实现了 ROSC，4 名（2.9%）患者至少存活 30 天，1 名患者在 30 天时有良好的神经结局。心脏骤停部位和初始节律与更好的结局相关。
在中国武汉，严重 COVID-19 肺炎患者发生 IHCA 的生存率较差。
