Zhou Xiaoqing, Sun Boru
Emergency Department Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Emerg Med Int. 2024 Sep 28;2024:2834376. doi: 10.1155/2024/2834376. eCollection 2024.
Over the years, numerous studies have suggested the occurrence of a peculiar phenomenon known as "CPRIC" during the revival process. The revelation of this phenomenon has ignited widespread discussion and investigation, yet many enigmas remain unsolved. This study describes the case of a 52-year-old man diagnosed with acute anterior myocardial infarction, who experienced ventricular fibrillation while awaiting further treatment. Despite ultimately not regaining spontaneous circulation, he remained conscious for a period during chest compressions and showed signs of resistance.
PubMed and Web of Science were searched until July 11, 2024. We included original studies and case reports relevant to CPRIC. For case reports, we extracted information on the author (year), country, patients, location, compression, signs of CPRIC, treatment of CPRIC, and patient outcomes. For other studies, we included the author (year), country, participants, and results. The extracted data were synthesized using a narrative approach.
Of 3038 articles, 32 were included, i.e., 18 case reports (24 cases), 9 cross-sectional surveys, and 5 cohort studies. In CPRIC cases, patients exhibited various manifestations including opening their eyes, speaking, and moving. Other included studies explored healthcare workers' awareness and experiences of CPRIC, the incidence and manifestations of CPRIC, the impact of CPRIC on patient outcomes, memories and perceptions of cardiac arrest indicating consciousness, the effects of CPRIC on rescuers, and the management of CPRIC.
There is an urgent need to establish a globally recognized definition of CPRIC. It is crucial to develop clear algorithms that focus not only on identifying this phenomenon but also on determining the best approaches to manage it. Furthermore, CPRIC can cause multiple interruptions during CPR, making it essential to differentiate whether these interruptions are due to CPRIC or indicative of a return of spontaneous circulation.
多年来，众多研究表明在复苏过程中会出现一种被称为“心肺复苏期间意识存在（CPRIC）”的特殊现象。这一现象的揭示引发了广泛的讨论和调查，但许多谜团仍未解开。本研究描述了一名52岁男性患者的病例，该患者被诊断为急性前壁心肌梗死，在等待进一步治疗时发生心室颤动。尽管最终未恢复自主循环，但他在胸外按压期间保持了一段时间的意识，并表现出抵抗迹象。
检索了截至2024年7月11日的PubMed和Web of Science数据库。我们纳入了与CPRIC相关的原始研究和病例报告。对于病例报告，我们提取了作者（年份）、国家、患者、地点、按压情况、CPRIC体征、CPRIC治疗方法以及患者结局等信息。对于其他研究，我们纳入了作者（年份）、国家、参与者和结果等信息。提取的数据采用叙述性方法进行综合分析。
在3038篇文章中，纳入了32篇，即18篇病例报告（24例）、9篇横断面调查和5篇队列研究。在CPRIC病例中，患者表现出各种表现，包括睁眼、说话和活动。其他纳入的研究探讨了医护人员对CPRIC的认识和经验、CPRIC的发生率和表现、CPRIC对患者结局的影响、心脏骤停时意识存在的记忆和认知、CPRIC对救援人员的影响以及CPRIC的管理。
迫切需要建立一个全球公认的CPRIC定义。制定清晰的算法至关重要，这些算法不仅要专注于识别这一现象，还要确定最佳的管理方法。此外，CPRIC可在心肺复苏期间导致多次中断，因此区分这些中断是由于CPRIC还是自发循环恢复的迹象至关重要。
