JACC:不应过早放弃心肺复苏过程中出现喘气症状的患者

2017-09-18 MedSci MedSci原创

"喘"是心肺复苏过程中人体为了增大吸氧量和循环量的自然反应。近日,在国际心血管权威杂志JACC上发表了一篇旨在评估院外心脏停搏出现喘气症状与患者1年生存预后关系的临床研究。本研究纳入搜集了2007年8月至2009年7月院外心脏停搏多中心随机对照研究中出现喘气症状的患者,患者1年后生存预后神经功能良好的标准为脑功能评分(CPC)≤2分。最终结果显示,CPC≤2分的患者占所有患者的5.4%(98/18

"喘"是心肺复苏过程中人体为了增大吸氧量和循环量的自然反应。近日,在国际心血管权威杂志JACC上发表了一篇旨在评估院外心脏停搏出现喘气症状与患者1年生存预后关系的临床研究。本研究纳入搜集了2007年8月至2009年7月院外心脏停搏多中心随机对照研究中出现喘气症状的患者,患者1年后生存预后神经功能良好的标准为脑功能评分(CPC)≤2分。最终结果显示,CPC≤2分的患者占所有患者的5.4%(98/1827),占心肺复苏过程中出现有喘气症状患者的20%(36/177),占没有喘气症状患者的3.7%(61/1643)。多元回归分析后发现,1年后CPC≤2分与低龄([OR] 0.57; 95% [CI]: 0.43 - 0.76))、心肺复苏过程中出现喘气(OR: 3.94; 95% CI: 2.09 - 7.44)、短的心肺复苏时间(OR: 0.31; 95% CI: 0.19 - 0.51)、低肾上腺素剂量(OR: 0.47; 95% CI: 0.25 - 0.87)和肺水肿(OR: 3.41; 95% CI: 1.53 - 7.60)呈相关性。此外,喘气加上可电击复律心律可以提高OR值57

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  1. 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content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-23 hbwxf
  2. 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    2018-07-06 aids222
  3. 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content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-20 lizhou0204
  4. 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  5. 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content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-19 1e207054m17(暂无匿称)

    坚持.有些人会有奇迹.大部分时间都是白忙乎

    0

  6. 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content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-18 131****1460

    学习了受益匪浅

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Sep 18 13:36:33 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245326, encodeId=a82e2453262c, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Sep 18 13:30:30 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245317, encodeId=790324531e37, content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-18 tanxingdoctor

    学习啦!谢谢分享!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1853777, encodeId=36511853e776d, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Sep 23 07:58:00 CST 2017, time=2017-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684457, encodeId=2d72168445e0a, content=<a href='/topic/show?id=dfae5133e1d' target=_blank style='color:#2F92EE;'>#心肺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51337, encryptionId=dfae5133e1d, topicName=心肺)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8e128082444, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Sep 18 13:36:33 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245326, encodeId=a82e2453262c, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Sep 18 13:30:30 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245317, encodeId=790324531e37, content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-18 惠映实验室

    学习了.谢谢.

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1853777, encodeId=36511853e776d, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Sep 23 07:58:00 CST 2017, time=2017-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684457, encodeId=2d72168445e0a, content=<a href='/topic/show?id=dfae5133e1d' target=_blank style='color:#2F92EE;'>#心肺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51337, encryptionId=dfae5133e1d, topicName=心肺)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8e128082444, 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Sep 18 19:20:49 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245389, encodeId=b9b724538934, content=学习啦!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon Sep 18 18:50:22 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245328, encodeId=73b424532873, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Sep 18 13:36:33 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245326, encodeId=a82e2453262c, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Sep 18 13:30:30 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245317, encodeId=790324531e37, content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-18 王秀

    学习了.涨知识了!

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Sep 18 13:36:33 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245326, encodeId=a82e2453262c, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Sep 18 13:30:30 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245317, encodeId=790324531e37, content=坚持住.不放弃., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Sep 18 12:39:35 CST 2017, time=2017-09-18, status=1, ipAttribution=)]
    2017-09-18 1e0f8808m18(暂无匿称)

    坚持住.不放弃.

    0

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目前,对于代谢正常的肥胖患者的心血管危险因素尚未阐明。近日,在国际心血管权威杂志JACC上发表了一篇旨在评估代谢正常的肥胖患者与4种不同的心血管疾病发生之间相关性的临床研究。本研究纳入了1995年至2015年美国电子数据库的350万名研究对象,年龄均在18岁及以上,并且最开始均无心血管疾病史。通过体重指数(BMI),将所有研究对象分成不同组别,包括低体重、正常体重、超重和肥胖,并根据代谢类型分成糖

JACC:搭桥vsPCI—伴1型糖尿病心血管疾病患者治疗的选择

对于伴有多支血管病变的1型糖尿病(T1D)患者,搭桥手术或者经皮冠脉介入治疗(PCI)的收益哪种更大尚未阐明。本研究纳入了瑞典1995年至2013年行首次多血管重建手术的T1D患者,并通过多个数据库对患者的临床信息和预后进行全面的评估分析。最终,共纳入了683名接受搭桥手术治疗的患者和1863名接受PCI治疗的患者,经过平均10.6年时间的随访,搭桥治疗组的53%患者和PCI治疗组的45%患者死亡

JACC:左房纤维化会增加房颤患者心脑血管不良事件发生风险

左房纤维化严重程度是房颤患者消融成功的关键因素之一,并与患者的卒中、高血压和心衰病史呈相关性。然而,严重的左房纤维化是否会增加房颤患者的主要心脑血管不良事件(MACCE)尚属未知。本回顾性研究纳入了2007年1月至2015年6月1228名行心脏磁共振检查左房纤维化程度的房颤患者,根据严重程度对其进行分组,并随访评估其MACCE发生的概率,包括卒中或短暂性脑缺血发作(TIA)、心梗、急性失代偿心衰或

JACC:PSCK9可作为房颤患者心血管不良事件发生的预测因子

既往研究证实可溶性蛋白转化酶枯草溶菌素9(PCSK9)可作为高风险心血管疾病患者的心血管事件(CVEs)发生的预测因子,然而,对于房颤患者,PCSK9的预测效果如何尚未阐明。本研究纳入了907名接受维生素K抗凝治疗的房颤患者,对其CVEs进行评估,包括致死性或非致死性心梗、缺血性卒中和心源性死亡。入院时,对患者的PCSK9和血小板激活的标志物-尿11脱氢血栓素B2((11-dh-TxB2)水平进行

JACC:伴有左室功能不全的捐赠者的心脏可以移植吗?

左心室收缩功能不全(LVSD)约占心脏捐赠失败原因的25%,既往的小型单中心研究显示脑死亡后的LVSD是瞬间的,一旦问题解决后心脏仍然可以进行捐赠。本研究回顾了2007年1月1日至2015年9月30日美国器官捐赠数据库捐赠者的超声心动图结果,最终选出472名原始经胸超声心动图诊断出LVSD(左室射血分数≤40%),随后又恢复正常的捐赠者,这些患者组成左室射血分数提高组,并与左室射血分数一开始就正常