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一项关于院外心脏骤停患者及家属接受体外心肺复苏(ECPR)体验的定性探索性病例系列研究。

A qualitative exploratory case series of patient and family experiences with ECPR for out-of-hospital cardiac arrest.

作者信息

Grunau Brian, Dainty Katie, MacRedmond Ruth, McDonald Ken, Sasaki Ayumi, Sarti Aimee J, Shemie Sam D, Cheung Anson, Gill John

机构信息

Department of Emergency Medicine, University of British Columbia, Canada.

Centre for Health Evaluation & Outcome Sciences, Vancouver, B.C., Canada.

出版信息

Resusc Plus. 2021 Apr 28;6:100129. doi: 10.1016/j.resplu.2021.100129. eCollection 2021 Jun.

Abstract

OBJECTIVE

There is currently no existing data examining the opinions of patients and families after treatment with extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA). We sought to interview family members and patients to learn from their experiences and satisfaction with treatment.

METHODS

We contacted family members and survivors for all cases treated with ECPR for refractory OHCA at St. Paul's Hospital between January 2014 and July 2018. We performed semi-structured interviews with participants, specifically within the topics of: information sharing (including impressions of an ECPR informational pamphlet), prognostication, organ donation, and perceived value of ECPR. Due to low participant enrolment, we described all interviews in a narrative approach.

RESULTS

Within the study period, there were 23 OHCAs treated with ECPR; two survivors and three family members agreed to participate. Participants were satisfied with the treatment provided, including information sharing and prognostication. There were mixed opinions about the best method of information-sharing (verbal vs written), as well as the timing of organ donation conversations. All participants believed ECPR for OHCA to be of high value.

CONCLUSION

Patient's conveyed satisfaction with ECPR treatment, with mixed views on the best information sharing strategy. Further study is needed to define the optimal methods and timing for discussions of organ donation, especially for treatments of with a relatively low likelihood success.

摘要

目的

目前尚无关于院外心脏骤停(OHCA)患者接受体外心肺复苏(ECPR)治疗后患者及其家属意见的现有数据。我们试图采访家属和患者,以了解他们的治疗经历和满意度。

方法

我们联系了2014年1月至2018年7月期间在圣保罗医院接受ECPR治疗的难治性OHCA所有病例的家属和幸存者。我们对参与者进行了半结构化访谈,具体涉及以下主题:信息共享(包括对ECPR信息手册的印象)、预后判断、器官捐献以及ECPR的感知价值。由于参与人数较少,我们采用叙述方式描述了所有访谈。

结果

在研究期间,有23例OHCA接受了ECPR治疗;两名幸存者和三名家属同意参与。参与者对所提供的治疗感到满意,包括信息共享和预后判断。对于最佳信息共享方式(口头与书面)以及器官捐献谈话的时机存在不同意见。所有参与者都认为OHCA的ECPR具有很高的价值。

结论

患者对ECPR治疗表示满意,但对最佳信息共享策略看法不一。需要进一步研究以确定器官捐献讨论的最佳方法和时机,特别是对于成功率相对较低的治疗。

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