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自动体外除颤器在院外心脏骤停生存率及预后中的作用:一项系统评价

The Role of Automated External Defibrillator Use in the Out-of-Hospital Cardiac Arrest Survival Rate and Outcome: A Systematic Review.

作者信息

Elhussain Mohamed O, Ahmed Fatima K, Mustafa Nafisa M, Mohammed Doaa O, Mahgoub Ibrahim M, Alnaeim Namarig A, Ali Ragda, Bushra Noura, Ahamed Hassan K, Abdelrahman Nadir

机构信息

Family Medicine-Geriatrics, Michigan State University, East Lansing, USA.

Internal Medicine, Sudan Medical Specialization Board, Khartoum, SDN.

出版信息

Cureus. 2023 Oct 26;15(10):e47721. doi: 10.7759/cureus.47721. eCollection 2023 Oct.

Abstract

Out-of-hospital cardiac arrest (OHCA) remains a significant cause of death. The chance of survival significantly increases when immediate defibrillation with an on-site automated external defibrillator (AED) is available. Our aim is to systematically evaluate the impact of public access defibrillators (PAD) on the outcomes of outpatient cardiac arrest. We conducted a systematic review of the data from global studies on the role of bystander and emergency medical service (EMS) interventions, primarily focusing on the usage of AEDs, during OHCA events. The results highlight the critical significance of PADs in improving survival outcomes in OHCA settings. The majority of OHCA incidents occurred in private residences, but public spaces such as schools and airports had better outcomes, likely due to AED accessibility and trained individuals. Placing AEDs in public areas, especially high-risk zones, can boost survival chances. Timely defibrillation, particularly by bystanders, correlated with better survival and neurological conditions. The review emphasizes the importance of widespread cardiopulmonary resuscitation (CPR) and AED training, strategic AED placement, and continuous monitoring of interventions and outcomes to enhance survival rates and neurological recovery after OHCAs. This systematic review showed that bystander interventions, including CPR and AED usage, significantly increased the survival rate. Overall, immediate response and accessibility to AEDs in public areas can significantly improve outcomes in OHCA events.

摘要

院外心脏骤停(OHCA)仍然是一个重要的死亡原因。当现场有自动体外除颤器(AED)可立即进行除颤时,存活几率会显著增加。我们的目的是系统评估公众可获取除颤器(PAD)对院外心脏骤停患者预后的影响。我们对全球关于旁观者和紧急医疗服务(EMS)干预作用的研究数据进行了系统回顾,主要关注院外心脏骤停事件期间AED的使用情况。结果凸显了PAD在改善院外心脏骤停情况下存活预后方面的关键意义。大多数院外心脏骤停事件发生在私人住宅,但学校和机场等公共场所的预后较好,这可能是由于AED的可及性以及有经过培训的人员。在公共区域,尤其是高风险区域放置AED,可以提高存活几率。及时除颤,特别是由旁观者进行除颤,与更好的存活情况和神经状况相关。该综述强调了广泛开展心肺复苏(CPR)和AED培训、合理放置AED以及持续监测干预措施和预后情况以提高院外心脏骤停后的存活率和神经功能恢复的重要性。这项系统回顾表明,包括CPR和AED使用在内的旁观者干预显著提高了存活率。总体而言,在公共区域对AED的即时响应和可及性可显著改善院外心脏骤停事件的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baf/10676231/3b6fd0609276/cureus-0015-00000047721-i01.jpg

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