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心脏骤停:2020年临床文献的跨学科范围综述

Cardiac arrest: An interdisciplinary scoping review of clinical literature from 2020.

作者信息

Murphy Travis W, Cohen Scott A, Hwang Charles W, Avery K Leslie, Balakrishnan Meenakshi P, Balu Ramani, Chowdhury Muhammad Abdul Baker, Crabb David B, Elmelige Yasmeen, Maciel Carolina B, Gul Sarah S, Han Francis, Becker Torben K

机构信息

Division of Critical Care Medicine Department of Emergency Medicine University of Florida Gainesville Florida USA.

Cardiothoracic Critical Care Miami Transplant Institute University of Miami Miami Florida USA.

出版信息

J Am Coll Emerg Physicians Open. 2022 Jul 14;3(4):e12773. doi: 10.1002/emp2.12773. eCollection 2022 Aug.

Abstract

OBJECTIVES

The Interdisciplinary Cardiac Arrest Research Review (ICARE) group was formed in 2018 to conduct an annual search of peer-reviewed literature relevant to cardiac arrest. Now in its third year, the goals of the review are to highlight annual updates in the interdisciplinary world of clinical cardiac arrest research with a focus on clinically relevant and impactful clinical and population-level studies from 2020.

METHODS

A search of PubMed using keywords related to clinical research in cardiac arrest was conducted. Titles and abstracts were screened for relevance and sorted into 7 categories: Epidemiology & Public Health Initiatives; Prehospital Resuscitation, Technology & Care; In-Hospital Resuscitation & Post-Arrest Care; Prognostication & Outcomes; Pediatrics; Interdisciplinary Guidelines & Reviews; and a new section dedicated to the coronavirus disease 2019 (COVID-19) pandemic. Screened manuscripts underwent standardized scoring of methodological quality and impact on the respective fields by reviewer teams lead by a subject matter expert editor. Articles scoring higher than 99 percentiles by category were selected for full critique. Systematic differences between editors' and reviewers' scores were assessed using Wilcoxon signed-rank test.

RESULTS

A total of 3594 articles were identified on initial search; of these, 1026 were scored after screening for relevance and deduplication, and 51 underwent full critique. The leading category was Prehospital Resuscitation, Technology & Care representing 35% (18/51) of fully reviewed articles. Four COVID-19 related articles were included for formal review that was attributed to a relative lack of high-quality data concerning cardiac arrest and COVID-19 specifically by the end of the 2020 calendar year. No significant differences between editor and reviewer scoring were found among review articles ( = 0.697). Among original research articles, section editors scored a median 1 point (interquartile range, 0-3;  < 0.01) less than reviewers.

CONCLUSIONS

Several clinically relevant studies have added to the evidence base for the management of cardiac arrest patients including methods for prognostication of neurologic outcome following arrest, airway management strategy, timing of coronary intervention, and methods to improve expeditious performance of key components of resuscitation such as chest compressions in adults and children.

摘要

目的

跨学科心脏骤停研究综述(ICARE)小组于2018年成立,旨在每年对与心脏骤停相关的同行评审文献进行检索。如今已进入第三年,该综述的目标是突出临床心脏骤停研究跨学科领域的年度更新,重点关注2020年具有临床相关性且有影响力的临床和人群水平研究。

方法

使用与心脏骤停临床研究相关的关键词在PubMed上进行检索。对标题和摘要进行相关性筛选,并分为7类:流行病学与公共卫生倡议;院外复苏、技术与护理;院内复苏与骤停后护理;预后与结局;儿科;跨学科指南与综述;以及一个专门针对2019冠状病毒病(COVID-19)大流行的新板块。由主题专家编辑带领的评审团队对筛选出的手稿进行方法学质量和对各自领域影响的标准化评分。对各分类中得分高于第99百分位数的文章进行全面评估。使用Wilcoxon符号秩检验评估编辑和评审人员评分之间的系统差异。

结果

初步检索共识别出3594篇文章;其中,1026篇经相关性筛选和重复数据删除后进行评分,51篇接受全面评估。主导类别是院外复苏、技术与护理,占全面评估文章的35%(18/51)。纳入了4篇与COVID-19相关的文章进行正式评审,这归因于到2020年年底,关于心脏骤停和COVID-19的高质量数据相对缺乏。在评审文章中,未发现编辑和评审人员评分之间存在显著差异( = 0.697)。在原创研究文章中,各板块编辑的评分中位数比评审人员低1分(四分位间距,0 - 3; < 0.01)。

结论

多项具有临床相关性的研究为心脏骤停患者的管理增加了证据基础,包括骤停后神经学结局的预测方法、气道管理策略、冠状动脉介入时机,以及提高复苏关键环节(如成人和儿童胸外按压)快速执行的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/646f/9282171/5ae27eabb6f6/EMP2-3-e12773-g001.jpg

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