JAMA:复苏过程中使用亚硝酸钠不能提高院外心脏骤停患者存活率

2021-01-18 MedSci原创 MedSci原创

对于院外心脏骤停患者,在复苏过程中进行亚硝酸钠注射治疗不能改善患者预后,研究结论不支持亚硝酸钠用于院外心脏骤停患者的复苏

院外心脏骤停患者往往由于救援延迟导致不良预后风险增加,虽然近年来相关急救知识及设备的普及率增加,但2005-15年间的统计数据表明,超过80%的院外心脏骤停患者在循环恢复后仍会在出院前死亡。亚硝酸盐治疗可抑制缺血再灌注后的细胞损伤和凋亡,在局灶性缺血动物模型中具有细胞保护作用。近日研究人员考察了医护人员在院外心脏骤停复苏过程中给予亚硝酸钠肠外治疗是否能提高患者的出院生存率。
 
本次研究为II期,双盲,安慰剂对照研究,1502名来自华盛顿州的金县的院外心脏骤停患者参与,在院外心脏骤停复苏过程中,随机接受45mg亚硝酸钠(n=500)、60mg亚硝酸钠(n=498)或安慰剂(n=499)注射治疗。研究的主要终点为入院存活率,次要终点包括要院外结果(自发循环率、卧床率和去甲肾上腺素血压维持率)和院内结果(存活出院,出院时的神经结果,24、48以及72小时累计存活率,重症监护等)。
 
患者平均年龄64岁,女性占34%,99%的患者完成研究。总体上,45mg亚硝酸钠组205人存活入院(41%)、60mg亚硝酸钠组212人(43%),而安慰剂组218人(44%)。7个次要终点中,组间差异均不显著,包括患者出院存活,45mg亚硝酸钠组66人存活出院(13.2%)、60mg亚硝酸钠组72人(14.5%),而安慰剂组74人(14.9%)。
 
研究认为,对于院外心脏骤停患者,在复苏过程中进行亚硝酸钠注射治疗不能改善患者预后,研究结论不支持亚硝酸钠用于院外心脏骤停患者的复苏
 
原始出处
 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1862977, encodeId=2a4818629e7af, content=<a href='/topic/show?id=b5ca453451f' target=_blank style='color:#2F92EE;'>#存活率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45345, encryptionId=b5ca453451f, topicName=存活率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b3f89, createdName=daviiliu, createdTime=Mon Oct 11 22:32:45 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305519, encodeId=bda41305519e8, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305676, encodeId=615613056e68e, 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=41, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530851, encodeId=9d8b15308514a, content=<a href='/topic/show?id=114d2429957' target=_blank style='color:#2F92EE;'>#亚硝酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24299, encryptionId=114d2429957, topicName=亚硝酸钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b84c12156469, createdName=wujh_7312823, createdTime=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036400, encodeId=8e7a103640073, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 18 18:32:45 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1862977, encodeId=2a4818629e7af, content=<a href='/topic/show?id=b5ca453451f' target=_blank style='color:#2F92EE;'>#存活率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45345, encryptionId=b5ca453451f, topicName=存活率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b3f89, createdName=daviiliu, createdTime=Mon Oct 11 22:32:45 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305519, encodeId=bda41305519e8, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305676, encodeId=615613056e68e, 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=41, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530851, encodeId=9d8b15308514a, content=<a href='/topic/show?id=114d2429957' target=_blank style='color:#2F92EE;'>#亚硝酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24299, encryptionId=114d2429957, topicName=亚硝酸钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b84c12156469, createdName=wujh_7312823, createdTime=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036400, encodeId=8e7a103640073, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 18 18:32:45 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
    2021-01-20 lizhou0204
  3. [GetPortalCommentsPageByObjectIdResponse(id=1862977, encodeId=2a4818629e7af, content=<a href='/topic/show?id=b5ca453451f' target=_blank style='color:#2F92EE;'>#存活率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45345, encryptionId=b5ca453451f, topicName=存活率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b3f89, createdName=daviiliu, createdTime=Mon Oct 11 22:32:45 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305519, encodeId=bda41305519e8, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305676, encodeId=615613056e68e, 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=41, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530851, encodeId=9d8b15308514a, content=<a href='/topic/show?id=114d2429957' target=_blank style='color:#2F92EE;'>#亚硝酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24299, encryptionId=114d2429957, topicName=亚硝酸钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b84c12156469, createdName=wujh_7312823, createdTime=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036400, encodeId=8e7a103640073, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 18 18:32:45 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1862977, encodeId=2a4818629e7af, content=<a href='/topic/show?id=b5ca453451f' target=_blank style='color:#2F92EE;'>#存活率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45345, encryptionId=b5ca453451f, topicName=存活率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b3f89, createdName=daviiliu, createdTime=Mon Oct 11 22:32:45 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305519, encodeId=bda41305519e8, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305676, encodeId=615613056e68e, 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=41, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530851, encodeId=9d8b15308514a, content=<a href='/topic/show?id=114d2429957' target=_blank style='color:#2F92EE;'>#亚硝酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24299, encryptionId=114d2429957, topicName=亚硝酸钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b84c12156469, createdName=wujh_7312823, createdTime=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036400, encodeId=8e7a103640073, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 18 18:32:45 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1862977, encodeId=2a4818629e7af, content=<a href='/topic/show?id=b5ca453451f' target=_blank style='color:#2F92EE;'>#存活率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45345, encryptionId=b5ca453451f, topicName=存活率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b3f89, createdName=daviiliu, createdTime=Mon Oct 11 22:32:45 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305519, encodeId=bda41305519e8, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305676, encodeId=615613056e68e, 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=41, 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=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530851, encodeId=9d8b15308514a, content=<a href='/topic/show?id=114d2429957' target=_blank style='color:#2F92EE;'>#亚硝酸钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24299, encryptionId=114d2429957, topicName=亚硝酸钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b84c12156469, createdName=wujh_7312823, createdTime=Wed Jan 20 06:32:45 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036400, encodeId=8e7a103640073, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 18 18:32:45 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
    2021-01-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

相关资讯

直肠黏膜环切手术中心搏骤停1例

心搏骤停是手术麻醉过程中最严重的突发事件,死亡率高,部分患者可导致神经系统并发症,严重威胁患者生命安全并影响其生存质量。导致围术期心搏骤停的相关因素有缺氧、手术因素、药物因素、术前心功能差、肺栓塞、电

JACC:心脏骤停与遗传学心脏病的分析研究

本研究的目的旨在评估导致复苏性心脏骤停(RSCA)的各遗传学心脏病(CID)的比例。

J Am Heart Assoc :心脏骤停临床预测模型有助于指导患者后续的治疗决策

无论是在院外还是院内,突发心脏骤停(Sudden cardiac arrest,SCA)患者的存活率均明显偏低,存活患者预后神经系统良好的比例更是极低。

Circulation:非ST段抬高型患者心脏骤停复苏后是否需要进行早期冠状动脉造影?

对于非ST段抬高型患者,院外心脏骤停复苏后进行紧急冠状动脉造影的益处尚不确定。该研究是一项随机临床试验,旨在评估

Lancet:低温导致心脏骤停6小时后神经功还能完全恢复?

34岁,女性。在西班牙北部的一次登山旅行中倒下,最初在一个救援中心接受了评估。

Circulation:心脏骤停的自身抗体特征!

心脏骤停是一种悲剧,在世界范围内,大约每90秒就有一人死于心脏骤停。幸存者通常会接受检查,以确定骤停的原因。但约5%-10%的心脏骤停仍原因不明。因为心律失常是大多数心脏骤停的基础,而且越来越多的证据