JAMA:儿童心脏骤停患者心肺复苏过程中血压因素对患儿预后的影响

2022-03-09 MedSci原创 MedSci原创

在儿童心脏骤停心肺复苏过程中,考虑骤停期舒张压以及循环恢复后收缩压水平不会对改善患儿神经预后有显著影响

2019年数据显示,美国每年有超过15000 名住院儿童患者经历心脏骤停并接受心肺复苏(CPR),其中95%以上发生在重症监护病房(ICU),约60%的心脏骤停患儿死亡。美国心脏协会(AHA)的CPR指南主要强调CPR力学指标,如按压力度和频率。近日研究人员考察了在CPR时,增加心脏骤停期舒张压以及循环恢复后收缩压水平对患儿预后的影响。

ICU-RESUS研究涉及美国10个临床中心的18个儿童重症监护病房(ICUs),总计1129例小儿ICU患者在研究期间进行了CPR,其中526名患儿接受了ICU循环复苏改进护理(对医护人员进行每月48小时培训),548名患儿接受常规CPR。研究的主要终点为神经功能预后良好人群的出院存活率(定义为儿童大脑功能类别评分为1到3分或与基线检查无变化),次要终点为存活出院。
在1276名患儿经历了1389次心脏骤停,其中1129次CPR事件纳入研究,患儿中位年龄0.6岁,499名女孩(44%)。干预组(53.8%)与对照组(52.4%)在神经系统预后的情况下的存活出院率无显著差异(RD=3.2%,调整后的OR为1.08)。次要终点方面,干预组(58.0%)与对照组(56.8%)的出院生存率也无显著差异(RD=1.6%,调整后OR为1.03)


研究认为,在儿童心脏骤停心肺复苏过程中,考虑骤停期舒张压以及循环恢复后收缩压水平不会对改善患儿神经预后有显著影响
原始出处:
The ICU-RESUS and Eunice Kennedy Shriver National Institute of Child Health; and Human Development Collaborative Pediatric Critical Care Research Network Investigator Groups.Effect of Physiologic Point-of-Care Cardiopulmonary Resuscitation Training on Survival With Favorable Neurologic Outcome in Cardiac Arrest in Pediatric ICUs A Randomized Clinical Trial. JAMA,March 8,2022。

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    2022-05-31 aids222
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    2022-03-11 lizhou0204
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    2022-03-10 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2022-03-09 1251aaefm11(暂无昵称)

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