院外心脏骤停结局、呼气末二氧化碳和体外心肺复苏资格：新南威尔士州试点数据。
Out-of-hospital cardiac arrest outcomes, end-tidal carbon dioxide and extracorporeal cardiopulmonary resuscitation eligibility: New South Wales pilot data.
机构信息
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
出版信息
Emerg Med Australas. 2022 Jun;34(3):452-455. doi: 10.1111/1742-6723.13972. Epub 2022 Apr 7.
OBJECTIVE
To describe on-scene times for out-of-hospital cardiac arrests (OHCA) transferred to hospital, the number of these that were extracorporeal cardiopulmonary resuscitation (ECPR) eligible and potential association between end-tidal carbon dioxide (ETCO ) and survival so as to inform planned interventional studies.
METHODS
Prospective cohort study of all OHCA, of suspected medical cause, where resuscitation was commenced and who were transported to participating hospitals from October 2020 to May 2021.
RESULTS
One hundred and forty-nine OHCA were included. Forty-four (30%) patients survived to hospital discharge. Eighteen (8%) met ECPR inclusion criteria. Median on-scene time was 33 min (interquartile range [IQR] 24-44). Initial hospital ETCO for non-survivors was 35 mmHg (IQR 19-50), survivors 36 mmHg (IQR 33-45); P = 0.215. No patient with an ETCO less than 20 mmHg on hospital arrival to survived to hospital discharge.
CONCLUSIONS
Average on-scene time did not differ on survivorship. A small number of transferred patients with OHCA were ECPR eligible. ETCO less than 20 mmHg portends adverse prognosis. Our data will be used for future interventional studies.
目的
描述院外心脏骤停（OHCA）患者的现场时间、可进行体外心肺复苏术（ECPR）的患者数量，以及呼气末二氧化碳（ETCO ）与生存率之间的潜在关联，为计划开展的干预性研究提供信息。
方法
这是一项对 2020 年 10 月至 2021 年 5 月期间所有疑似心源性 OHCA 患者的前瞻性队列研究，这些患者接受了复苏治疗并被转运至参与医院。
结果
共纳入 149 例 OHCA 患者，44 例（30%）患者存活至出院。18 例（8%）符合 ECPR 纳入标准。中位数现场时间为 33 分钟（IQR 24-44）。非幸存者的初始医院 ETCO 为 35mmHg（IQR 19-50），幸存者为 36mmHg（IQR 33-45）；P=0.215。没有一名入院时 ETCO 低于 20mmHg 的患者存活至出院。
结论
生存率与现场时间平均水平无差异。少数转运的 OHCA 患者符合 ECPR 标准。ETCO 低于 20mmHg 预示着预后不良。我们的数据将用于未来的干预性研究。
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