病院前の再発後の胸部圧縮と除細動への遅延

Joshua M Kimbrell¹, Judah A Kreinbrook², Jacob Stebel¹

¹Department of Pre-Hospital Care, Jamaica Hospital Medical Center, Queens, NY, USA.

The American journal of emergency medicine

|August 24, 2025

まとめ

胸部圧縮と除細動が著しく遅れた後,自発的循環 (ROSC) の再発は一般的です. これらの遅延は,心停止患者の生存率に影響を与える可能性があります.

科学分野:

緊急医療
心臓病科
蘇生科学

背景:

自発的な循環 (ROSC) の回復後の病院前再発は,生存の悪い結果と関連しています.
胸部圧縮と再発動の遅延は十分に理解されていません.

研究の目的:

病院前の再発後の胸圧縮と除細動の遅延を特徴付ける.
治療のタイミングを分析する.

主な方法:

現場でのROSC (2021-2023) の病院外心停止患者の遡及分析.
ROSCは60秒で胸の圧迫や血流の無いリズムが
リズム発現 (VF/asystole) から介入までの測定遅延;モニターの切り離しの時間を用いて患者の動きを推論した.

主要な成果:

患者のほぼ半分 (49%) が再発を経験した.
大幅な遅延が観察された: 60% のアシストールと 80% の心房細動 (VF) は> 10 秒の遅延に直面した.
VF再発では,デフィブリレーションが平均67秒遅れたが,20%はデフィブリレーションされなかった.
患者の移動前または移動中に再発しました.

結論:

このコホートでは高い再発率と治療の遅延が確認された.
治療の遅延と成果を関連付けるためのさらなる研究が必要です.
治療の遅延を緩和する戦略を調査することは生存率を改善するために不可欠です.

キーワード:

デフィブリレーション緊急医療サービス病院外での心停止病院前再び逮捕する

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