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韩国心脏骤停后护理的结果与现状:来自韩国低温治疗网络前瞻性登记研究的结果

Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry.

作者信息

Kim Soo Hyun, Park Kyu Nam, Youn Chun Song, Chae Minjung Kathy, Kim Won Young, Lee Byung Kook, Lee Dong Hoon, Jang Tae Chang, Lee Jae Hoon, Choi Yoon Hee, You Je Sung, Cho In Soo, Kim Su Jin, Lee Jong-Seok, Kim Yong Hwan, Sim Min Seob, Shin Jonghwan, Park Yoo Seok, Lee Young Hwan, Moon HyungJun, Jeong Won Jung, Oh Joo Suk, Choi Seung Pill, Cha Kyoung-Chul

机构信息

Department of Emergency Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Department of Emergency Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

出版信息

Clin Exp Emerg Med. 2020 Dec;7(4):250-258. doi: 10.15441/ceem.20.035. Epub 2020 Dec 31.

Abstract

OBJECTIVE

High-quality intensive care, including targeted temperature management (TTM) for patients with postcardiac arrest syndrome, is a key element for improving outcomes after out-of-hospital cardiac arrest (OHCA). We aimed to assess the status of postcardiac arrest syndrome care, including TTM and 6-month survival with neurologically favorable outcomes, after adult OHCA patients were treated with TTM, using data from the Korean Hypothermia Network prospective registry.

METHODS

We used the Korean Hypothermia Network prospective registry, a web-based multicenter registry that includes data from 22 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TTM between October 2015 and December 2018 were included. The primary outcome was neurological outcome at 6 months.

RESULTS

Of the 1,354 registered OHCA survivors treated with TTM, 550 (40.6%) survived 6 months, and 413 (30.5%) had good neurological outcomes. We identified 839 (62.0%) patients with preClinsumed cardiac etiology. A total of 937 (69.2%) collapses were witnessed, shockable rhythms were demonstrated in 482 (35.6%) patients, and 421 (31.1%) patients arrived at the emergency department with prehospital return of spontaneous circulation. The most common target temperature was 33°C, and the most common target duration was 24 hours.

CONCLUSION

The survival and good neurologic outcome rates of this prospective registry show great improvements compared with those of an earlier registry. While the optimal target temperature and duration are still unknown, the most common target temperature was 33°C, and the most common target duration was 24 hours.

摘要

目的

高质量的重症监护,包括对心脏骤停后综合征患者进行目标温度管理(TTM),是改善院外心脏骤停(OHCA)后结局的关键因素。我们旨在利用韩国低温网络前瞻性注册研究的数据,评估成年OHCA患者接受TTM治疗后心脏骤停后综合征的护理状况,包括TTM及6个月存活且神经功能良好的结局。

方法

我们使用了韩国低温网络前瞻性注册研究,这是一个基于网络的多中心注册研究,纳入了大韩民国22家参与医院的数据。纳入2015年10月至2018年12月期间接受TTM治疗的成年昏迷OHCA幸存者。主要结局是6个月时的神经功能结局。

结果

在1354例接受TTM治疗的注册OHCA幸存者中,550例(40.6%)存活6个月,413例(30.5%)神经功能良好。我们确定了839例(62.0%)有已知心脏病因的患者。共937例(69.2%)心脏骤停为目击事件,482例(35.6%)患者表现为可电击心律,421例(31.1%)患者在院前恢复自主循环后到达急诊科。最常见的目标温度为33°C,最常见的目标持续时间为24小时。

结论

与早期注册研究相比,该前瞻性注册研究的生存率和良好神经功能结局率有了很大提高。虽然最佳目标温度和持续时间仍不清楚,但最常见的目标温度为33°C,最常见的目标持续时间为24小时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/505d/7808836/befacc310c56/ceem-20-035f1.jpg

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