Sharma Sadhvi, Raman Padmalatha, Sinha Maneesh, Deo Alka S
Department of Anaesthesiology and Critical Care, NU Hospitals, Bengaluru, Karnataka, India.
Department of Urology, NU Hospitals, Bengaluru, Karnataka, India.
Indian J Crit Care Med. 2022 Mar;26(3):322-326. doi: 10.5005/jp-journals-10071-24146.
Availability of cardiopulmonary resuscitation (CPR) data from India is limited in published literature and data on patients with renal disease even more so. Documented survival-to-discharge rates worldwide range from 8 to 15% in renal disease as compared to 25% in the general population.
An institution-wide format for collection of cardiac arrest data was introduced in late 2015. We have analyzed all adult onsite cardiac arrests from January 2016 to December 2019. Patient characteristics and CPR parameters were both studied in detail. Primary endpoint was defined as survival to discharge. Association between patient and treatment characteristics and survival to discharge was studied.
Successful CPR resulting in patient discharge occurred in 28 (31.4%) out of 89 patients. A very strong association was found between mortality and prolonged CPR ( <0.00001). Events occurring out of hours ( = 0.0029), patients admitted in the intensive care unit (ICU) ( = 0.03), initiated on inotropes ( = 0.003), and patients already on a ventilator ( = 0.0018) had poorer outcomes. Sepsis as the etiology emerged as the most significant association with mortality ( = 0.0007). Patient characteristics such as age, sex, presence or absence of chronic kidney disease, type of dialysis treatment, and vintage were found to be insignificant.
Analysis revealed survival to discharge of 31.4%. Sepsis in association with renal disease has been found to be consistent with higher risk for mortality. Other factors such as an out of hours event, admission to ICU, early intubation and inotrope initiation were associated with worse outcomes.
Sharma S, Raman P, Sinha M, Deo AS. Factors Affecting Outcomes of Cardiopulmonary Resuscitation in a Nephro-Urology Unit: A Retrospective Analysis. Indian J Crit Care Med 2022;26(3):322-326.
已发表的文献中关于印度心肺复苏（CPR）数据的可用性有限，而关于肾病患者的数据更是如此。据记载，全球肾病患者出院生存率为8%至15%，而普通人群为25%。
2015年末引入了全机构范围的心脏骤停数据收集格式。我们分析了2016年1月至2019年12月期间所有成人现场心脏骤停情况。对患者特征和心肺复苏参数均进行了详细研究。主要终点定义为出院生存。研究了患者及治疗特征与出院生存之间的关联。
89例患者中有28例（31.4%）通过成功的心肺复苏实现出院。发现死亡率与长时间心肺复苏之间存在非常强的关联（<0.00001）。非工作时间发生的事件（=0.0029）、入住重症监护病房（ICU）的患者（=0.03）、开始使用血管活性药物的患者（=0.003）以及已使用呼吸机的患者（=0.0018）预后较差。作为病因的脓毒症与死亡率的关联最为显著（=0.0007）。发现患者特征如年龄、性别、是否存在慢性肾病、透析治疗类型和透析时间并无显著意义。
分析显示出院生存率为31.4%。已发现脓毒症合并肾病与更高的死亡风险一致。其他因素如非工作时间事件、入住ICU、早期插管和开始使用血管活性药物与较差的预后相关。
夏尔马S、拉曼P、辛哈M、迪奥AS。肾泌尿外科单元中心肺复苏结局的影响因素：一项回顾性分析。《印度重症监护医学杂志》2022年；26(3)：322 - 326。
