Herlitz J, Bång A, Holmberg M, Axelsson A, Lindkvist J, Holmberg S
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Resuscitation. 1997 Feb;34(1):17-22. doi: 10.1016/s0300-9572(96)01064-7.
To describe rhythm changes during the initial phase of resuscitation from ventricular fibrillation in relation to the interval between collapse and defibrillation, to survival and to bystander-initiated cardiopulmonary resuscitation (CPR).
All patients who suffered out-of-hospital cardiac arrest between 1980 and 1992, who were reached by the emergency medical service system (EMS), in whom resuscitation attempts were initiated and who were found in ventricular fibrillation.
In all, 1216 patients were included in the study. Among patients who converted to a pulse-generating rhythm after the first defibrillation (n = 119) were 56% discharged from hospital as compared with 6% among patients who converted to asystole. The corresponding figures after the third defibrillation were 49% and 2%, respectively, and after the fifth defibrillation 28% and 7%, respectively. Among patients in whom the first defibrillation took place less than 5 min after collapse, 28% directly converted to a pulse-generating rhythm as compared with 3% when the first defibrillation took place 12 min or more after collapse.
Among patients who suffer out-of-hospital cardiac arrest and are found in ventricular fibrillation, there is a strong relationship between survival and initial rhythm changes after defibrillation. These rhythm changes are directly related to the interval between collapse and the first defibrillation.
描述心室颤动复苏初始阶段的节律变化，及其与心脏停搏至除颤的时间间隔、生存率和旁观者实施的心肺复苏（CPR）之间的关系。
所有在1980年至1992年间发生院外心脏骤停、由紧急医疗服务系统（EMS）送达、已开始进行复苏尝试且被发现为心室颤动的患者。
该研究共纳入1216例患者。首次除颤后转为有脉搏节律的患者（n = 119）中，56%出院，而转为心搏停止的患者中这一比例为6%。第三次除颤后的相应数字分别为49%和2%，第五次除颤后分别为28%和7%。在心脏停搏后不到5分钟进行首次除颤的患者中，28%直接转为有脉搏节律，而在心脏停搏后12分钟或更长时间进行首次除颤的患者中这一比例为3%。
在发生院外心脏骤停且被发现为心室颤动的患者中，生存率与除颤后的初始节律变化之间存在密切关系。这些节律变化与心脏停搏至首次除颤的时间间隔直接相关。
