超正常氧气压力与心脏骤停后复苏后的结果之间的关系
J Hope Kilgannon1, Alan E Jones, Joseph E Parrillo
1Department of Emergency Medicine, Cooper University Hospital, Camden, NJ 08103, USA.
Circulation
|May 25, 2011
概括
心脏骤停后的高氧水平会以剂量依赖的方式增加死亡风险. 这项研究没有发现特定的有害氧值,强调了在复苏后的精心氧气管理.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 肺部医学 肺部医学
背景情况:
- 新出现的证据表明,在心脏骤停复苏后,高氧化是有害的.
- 氧气水平升高与不良结果之间的确切关系尚不清楚,关于值效应与剂量依赖关联的争论仍在进行中.
研究的目的:
- 调查动脉氧气 (PaO2) 的超正常部分压力与复苏后患者的住院死亡率之间的关联.
- 为了确定高氧化血的不良结果是否遵循值效应或剂量依赖的模式.
主要方法:
- 使用来自美国120家医院的IMPACT项目数据库进行的多中心队列研究.
- 包括在ICU入院前接受心肺复苏并进行复苏后血液气体分析的成年非创伤患者.
- 暴露定义为在ICU入院后24小时内达到最高的PaO2;主要结局是住院死亡率.
主要成果:
- 总共有4459名患者被分析,在医院死亡率为54%.
- 中位数PaO2是231毫米升 (IQR149-349).
- 增加PaO2显示出线性趋势,死亡率增加和生存率下降. 百毫米升的PaO2与24%的死亡风险上升相关 (OR 1.24,95% CI 1.18-1.31).
结论:
- 在复苏后患者中,超正常的氧气压力和住院死亡率之间存在显著的剂量依赖关系.
- 没有证据支持特定的危害门;较高的氧气水平持续增加死亡风险.
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