Circulation:心肺复苏或仅胸外按压对心脏骤停患者存活率的影响

2019-06-05 QQ MedSci原创

医院外心脏骤停时,单纯胸外按压心肺复苏(CO-CPR)已成为标准CPR (S-CPR)的替代方法,即同时进行胸外按压和人工呼吸。210年,CPR指南推荐未经过培训的路人和经过培训的路人可联合予以CO-CPR。现研究人员对在紧急医疗服务(EMS)到达前连续3个连续周期内CPR的发生率和类型与患者30天存活率的关系进行评估。纳入2000年-2017年所有瑞典登记的有目击者的院外心脏骤停。将患者按EMS

医院外心脏骤停时,单纯胸外按压心肺复苏(CO-CPR)已成为标准CPR (S-CPR)的替代方法,即同时进行胸外按压和人工呼吸。210年,CPR指南推荐未经过培训的路人和经过培训的路人可联合予以CO-CPR。现研究人员对在紧急医疗服务(EMS)到达前连续3个连续周期内CPR的发生率和类型与患者30天存活率的关系进行评估。

纳入2000年-2017年所有瑞典登记的有目击者的院外心脏骤停。将患者按EMS抵达前是否接受CPR及类型分类:无CPR(NO-CPR)、S-CPR和CO-CPR。根据指南的更新将本研究分成3个时间段:2000年-2005年、2006年-2010年和2010年-2017年。主要评估指标是患者30天内的存活率。

共纳入30445位患者。第一阶段、第二阶段和第三阶段在EMS抵达前接受CPR的患者比例分别是40.8%、58.8%和68.2%,接受S-CPR的比例分别是35.4%、44.8%和38.1%,接受CO-CPR的比例分别是5.4%、14.0%和30.1%。NO-CPR组各阶段的30天存活率分别是3.9%、6.0%和7.1%,S-CPR组的分别是9.4%、12.5% 和16.2%,CO-CPR组的分别是8.0%、11.5%和14.3%。结合所有时间段,与NO-CPR组相比,S-CPR和CO-CPR组30天存活率的校正优势比分别是2.6(95% CI 2.4-2.9)和2.0(1.8-2.3)。S-CPR的存活效益优于CO-CPR(校正优势比1.2,95% CI 1.1-1.4)。

从2000年到2017年,院外心脏骤停接受CPR的概率几乎升高了2倍,接受CO-CPR的概率增加了6倍。与无CPR相比,任何类型的CPR(有无人工呼吸)均可提高患者的存活率。


原始出处:

Gabriel Riva, et al. Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services. Circulation. 4 Jun 2019https://doi.org/10.1161/CIRCULATIONAHA.118.038179.2019;139:2600–2609

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    2019-08-04 aids222
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    2020-03-10 lisa446
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    2019-06-07 lizhou0204
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    2019-06-05 医者仁心5538

    学习了

    0

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    2019-06-05 qingfengqishi5

    学习了,学习了

    0

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2018年11月,欧洲复苏委员会(ERC)更新了复苏指南中关于心脏骤停抗心律失常药物的应用建议,2018欧洲更新版复苏指南主要聚焦心脏骤停高级生命支持期间抗心律失常药物的作用。

OCC 2019:中国心肺复苏周:健康从娃娃抓起,科技为生命接力

2019年6月1日,由中国医学救援协会、中国心血管健康联盟、美国华裔心脏协会联合发起的“中国心肺复苏周”启动仪式在上海世博中心隆重召开。“中国心肺复苏周”倡议心肺复苏(以下简称CPR)培训需全民普及,提议将每年6月1日-7日设为“中国心肺复苏周”,希望通过心肺复苏周的设立,培养民众急救意识,培训更多“第一目击人”,提高院外心脏骤停存活率,吸引更多社会资源投入,改善我国心源性猝死现状。启动仪式当天,

2018 美国心脏协会关于心肺复苏及心血管急救指南的重点更新:高级心血管生命支持及儿童高级生命支持(中文翻译版)

2015 年,国际复苏联络委员会 (ILCOR) 开始采用持续证据评估 (CEE) 流程。此流程用于快速分析同行评审的已发表的复苏研究以及心肺复苏 (CPR) 和心血管急救 (ECC) 科学与治疗建议 (CoSTR) 声明的国际共识的发展。持续证据评估旨在缩短复苏证据公布与转化成 ILCOR 成员(如美国心脏协会 (AHA))所提供指南建议之间的间隔时间。基于这些年度 ILCOR CoSTR 总结