Circulation:不同社区院外心脏骤停后路人心肺复苏的实施率和存活预后差异

2020-01-03 QQY MedSci原创

不同社区院外心脏骤停后的路人心肺复苏的实施和存活率各不相同,在以黑人为主的社区,存活率较低。尽管拉美裔人口是美国增长最快的少数族裔人口,但很少有研究评估拉美裔居民在社区中的比例是否与B-CPR的实施和院外心脏骤停的存活率有关。本研究是一项回顾性队列研究,采用复苏预后联盟Epistry的数据,评估B-CPR的发生率和存活率是否因社区种族而异。根据拉美裔居民的百分比将社区进行分类:<25%、25

不同社区院外心脏骤停后的路人心肺复苏的实施和存活率各不相同,在以黑人为主的社区,存活率较低。尽管拉美裔人口是美国增长最快的少数族裔人口,但很少有研究评估拉美裔居民在社区中的比例是否与B-CPR的实施和院外心脏骤停的存活率有关。

本研究是一项回顾性队列研究,采用复苏预后联盟Epistry的数据,评估B-CPR的发生率和存活率是否因社区种族而异。根据拉美裔居民的百分比将社区进行分类:<25%、25-50%、51-75%或>75%。

自2011年-2015年,复苏预后联盟共收集了27481例 US 骤停事件;排除儿科骤停、急诊医疗设备-监控的骤停或发生在医疗机构的骤停后,最终纳入18927例。在37%的事件中实施了B-CPR。在拉美裔居民<25%的社区中,B-CPR的实施率为39%,而在拉美裔居民>75%的社区中,B-CPR的实施率仅27%。在多变量分析中,与拉美裔居民<25%的社区相比,在拉美裔居民为主的社区中,B-CPR的实施率和存活率均较低。

拉美裔居民为主的社区中发生院外心脏骤停的个体获得B-CPR的概率更小,存活概率较低。本研究提示我们有必要了解在心肺复苏的宣传和非洲裔居民社区的心肺复苏培训需求。

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    2020-04-19 aids222
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    2020-01-05 qingfengqishi5

    学习了,学习了

    0

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    2020-01-05 lizhou0204
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1684551, encodeId=623d168455141, content=<a href='/topic/show?id=dfae5133e1d' target=_blank style='color:#2F92EE;'>#心肺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51337, encryptionId=dfae5133e1d, topicName=心肺)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8e128082444, createdName=aids222, createdTime=Sun Apr 19 19:47:00 CST 2020, time=2020-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819982, encodeId=744418199829b, content=<a href='/topic/show?id=2d131001813f' target=_blank style='color:#2F92EE;'>#预后差异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100181, encryptionId=2d131001813f, topicName=预后差异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Fri Apr 10 04:47:00 CST 2020, time=2020-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377833, encodeId=c6d03e783315, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Sun Jan 05 22:33:27 CST 2020, time=2020-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305502, encodeId=63441305502eb, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42724, encryptionId=270342e249d, topicName=复苏)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Sun Jan 05 14:47:00 CST 2020, time=2020-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305671, encodeId=cba613056e119, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Sun Jan 05 14:47:00 CST 2020, time=2020-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395850, encodeId=d7741395850b8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sun Jan 05 14:47:00 CST 2020, time=2020-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377758, encodeId=b50e3e775877, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/08/03/0e492dda8bcc1f98474b74c2863aca87.jpg, createdBy=068d2446376, createdName=Dr Z, createdTime=Sat Jan 04 07:12:14 CST 2020, time=2020-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377755, encodeId=03883e77550d, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Sat Jan 04 05:44:20 CST 2020, time=2020-01-04, status=1, ipAttribution=)]
    2020-01-04 Dr Z

    学习了

    0

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由此可见,在院外心脏骤停的成人中,使用肾上腺素导致30天生存率显著高于安慰剂,但患者有利的神经系统结局组间差异不显著,因为肾上腺素组有更多的幸存者出现严重的神经功能障碍。

Lancet:公共除颤设备改善院外心脏骤停患者预后

研究证实,公共除颤设备以及普及公共除颤常识对减少院外心脏骤停患者不良预后有显著效果

Eur Heart J:院外心脏骤停的体外心肺复苏

由此可见,在基于人群的登记中,有4%的OHCA接受了体外CPR治疗,但与医院生存率提高无关。早期植入ECMO可能会改善患者结局。初始心律和ROSC可能有助于选择进行体外CPR的患者。

2019 AHA科学声明:心导管室在管理院外心脏骤停患者的作用

2019年2月,美国心脏协会(AHA)发布了心导管室在管理院外心脏骤停(OHCA))患者的作用的科学声明,文章主要回顾OHCA患者冠状动脉疾病已知的患病率和潜在的重要性,并在现有的证据基础上,阐述先进的灌注/再灌注技术及其可能获益性。

Resuscitation:抗血小板治疗能否改善院外心脏骤停后患者结局?

2017年12月,发表在《Resuscitation》的一项由美国科学家进行的研究,考察了抗血小板治疗与院外心脏骤停(OHCA)后患者结局之间的相关性。

Chest:肺栓塞引起的院外心脏骤停复苏期间溶栓治疗可提高30天的生存率

由此可见,在确诊为PE且在住院期间自发循环恢复的OHCA患者中,CPR期间接受溶栓治疗的患者与未接受溶栓治疗的患者相比,30天生存率显著提高。