Li Hailin, Li Yinping, Chen Mingxian, Fu Rui, Ding Banghan
Corresponding author: Li Hailin, Department of Emergency, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Oct;35(10):1009-1025. doi: 10.3760/cma.j.cn121430-20230806-00582.
Reperfusion injury occurs after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA), which leads to multiple organ dysfunction, called post-cardiac arrest syndrome (PCAS). PCAS is closely related to the prognosis of CA patients, and is an independent risk factor of survival. Integrated traditional Chinese and Western medicine diagnosis and treatment is critical for improving prognosis of PCAS. In order to guide and standardize integrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians, nurses and research personnel in China, the Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine has established an expert group to determine 14 clinical issues related to the diagnosis and treatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey. The working group formulates a search strategy for each clinical issue according to the PICO principle. Chinese and English literature were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Cochrane Library. The grade of recommendations assessment, development and evaluation (GRADE) were used to form the level of evidence and recommendation. When the literature evidence was insufficient, the recommendations and level of recommendation were formed after expert discussion. Combined with the aspects of generalizability, suitability, and resource utilization, the expert consensus developed 28 recommendations around the 14 aspects of three stages of PCAS, including early circulation, respiratory support and reversible cause relief, mid-term neuroprotection, improvement of coagulation, prevention and treatment of infection, kidney and gastrointestinal protection and blood sugar control, post rehabilitation treatment, providing references for the integrated traditional Chinese and Western medicine of the diagnosis and treatment for PCAS.
心脏骤停（CA）患者自主循环恢复（ROSC）后会发生再灌注损伤，这会导致多器官功能障碍，即所谓的心搏骤停后综合征（PCAS）。PCAS与CA患者的预后密切相关，是生存的独立危险因素。中西医结合诊断和治疗对于改善PCAS的预后至关重要。为了在中国临床医生、护士和研究人员中指导和规范PCAS的中西医结合诊断和治疗，中国中西医结合学会急诊医学专业委员会成立了一个专家组，通过临床调查确定了14个与PCAS中西医结合诊断和治疗相关的临床问题。工作组根据PICO原则为每个临床问题制定检索策略。从中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase和Cochrane图书馆检索中英文文献。采用推荐意见评估、制定与评价分级（GRADE）来形成证据水平和推荐意见。当文献证据不足时，经专家讨论形成推荐意见和推荐等级。结合可推广性、适用性和资源利用等方面，专家共识围绕PCAS三个阶段的14个方面制定了28条推荐意见，包括早期循环、呼吸支持和解除可逆病因、中期神经保护、改善凝血、预防和治疗感染、肾脏和胃肠道保护以及血糖控制、后期康复治疗，为PCAS的中西医结合诊断和治疗提供参考。
