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对一家三级护理医院应急反应小组所提供的心肺复苏质量的评估。

Evaluation of the quality of cardiopulmonary resuscitation provided by the emergency response team at a tertiary care hospital.

作者信息

Maddani Sagar S, Chaudhuri Souvik, Krishna H M, Rao Shwethapriya, Unnithan Narayanan H, Ravindranath Sunil T

机构信息

Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Indian J Anaesth. 2022 Feb;66(2):126-132. doi: 10.4103/ija.ija_897_21. Epub 2022 Feb 24.

Abstract

BACKGROUND AND AIMS

Chest compression fraction is the proportion of time spent on chest compression during cardiopulmonary resuscitation (CPR). The aims of this study were to know the quality of CPR provided during in-hospital cardiac arrest (IHCA) by analysing the chest compression fraction and to see the correlation of chest compression fraction with return of spontaneous circulation (ROSC) in the hospital setting.

METHODS

This prospective observational study was conducted in patients aged >18 years who developed IHCA. An observer would assess the quality of CPR provided by noting the time spent on chest compression. The chest compression fraction was calculated and correlated in patients with ROSC and without ROSC. Patients who survived were followed until discharge, and their neurological score was determined using the cerebral performance category (CPC).

RESULTS

We included 126 patients in the study; the mean chest compression fraction achieved was 78% (standard deviation [SD] ± 5). A total of 73 (58%) patients achieved ROSC and among them, 11 patients (9%) survived to hospital discharge. We found that the patients with ROSC had a significantly higher chest compression fraction of 80% (SD ± 5), as compared to 75% (SD ± 5), in whom ROSC could not be achieved. A multivariate logistic regression test showed higher odds (1.125) of ROSC in patients with high chest compression fraction. The mean CPC among the survivors was 1.4 (SD ± 0.5).

CONCLUSION

Our study shows that health-care providers in our hospital provide high-quality CPR, and chest compression fraction is independently associated with ROSC in IHCA.

摘要

背景与目的

胸外按压分数是指在心肺复苏(CPR)过程中进行胸外按压所花费时间的比例。本研究的目的是通过分析胸外按压分数来了解院内心脏骤停(IHCA)期间实施的心肺复苏质量,并观察在医院环境中胸外按压分数与自主循环恢复(ROSC)之间的相关性。

方法

本前瞻性观察性研究针对年龄大于18岁且发生院内心脏骤停的患者开展。一名观察者会通过记录胸外按压所花费的时间来评估实施的心肺复苏质量。计算胸外按压分数,并将其与实现ROSC和未实现ROSC的患者进行相关性分析。对存活患者进行随访直至出院,并使用脑功能分类(CPC)确定其神经学评分。

结果

我们纳入了126例患者进行研究;所实现的平均胸外按压分数为78%(标准差[SD]±5)。共有73例(58%)患者实现了ROSC,其中11例(9%)存活至出院。我们发现,实现ROSC的患者胸外按压分数显著更高,为80%(SD±5),而未实现ROSC的患者胸外按压分数为75%(SD±5)。多因素逻辑回归测试显示,胸外按压分数高的患者实现ROSC的几率更高(1.125)。存活者的平均CPC为1.4(SD±0.5)。

结论

我们的研究表明,我院的医护人员提供了高质量的心搏骤停心肺复苏,且在院内心脏骤停中胸外按压分数与自主循环恢复独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df38/8963227/4d6c3fb5d34c/IJA-66-126-g001.jpg

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