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传统与只有压缩与无旁观者的心肺复苏

Tatsuma Fukuda1, Naoko Ohashi-Fukuda2, Hiroaki Kobayashi2

  • 1From Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of Tokyo, Japan (T.F., N.O-F., H.K., N.Y); Stephen M. Ross School of Business, University of Michigan, Ann Arbor (H.K.); Department of Disaster Medical Management, University of Tokyo Hospital, Japan (M.G.); The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (M.G.); Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University, Japan (T.S.); Department of Emergency Medicine, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan (Y.K.); and Division of Acute Care Surgery, Trauma, and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Y.K.). tatsumafukuda-jpn@umin.ac.jp.

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概括
此摘要是机器生成的。

常规心肺复苏 (CPR) 显示儿童在医院外心脏骤停 (OHCA) 的存活率较好,但随着统计调整,这种差异减少了. 这两种心肺复苏方法都优于无旁观者心肺复苏.

关键词:
心脏骤停进行心肺复苏孩子们在医院外发生心脏病发作儿童医学

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科学领域:

  • 儿童紧急医疗
  • 心血管研究
  • 公共卫生

背景情况:

  • 儿科外心脏骤停 (OHCA) 往往是窒息的,因此建议进行常规心肺复苏 (CPR),包括救援呼吸.
  • 传统心肺复苏与仅压缩心肺复苏在儿童中的比较有效性仍然不确定.

研究的目的:

  • 在儿童OHCA患者中比较传统心肺复苏和仅压缩心肺复苏的临床有效性.
  • 评估不同旁观者心肺复苏方法在OHCA后1个月的神经结果.

主要方法:

  • 使用全日本Utstein注册表 (2011-2012) 进行的全国性基于人口的研究.
  • 包括儿科OHCA患者.
  • 主要结果:一个月后神经状况良好 (格拉斯哥-匹兹堡大脑性能类别分数为1-2).
  • 使用逻辑回归 (单变量和多变量) 和倾向匹配子集的统计分析.

主要成果:

  • 包括2157名儿科OHCA患者:417名常规心肺复苏,733名仅进行压缩心肺复苏,1007名没有旁观者心肺复苏.
  • 总体有利的神经生存率为9. 9% (213名患者).
  • 与只有压缩的CPR相比,未经调整的常规CPR显示出较高的神经学上有利的生存率 (OR3. 42).
  • 在多变量调整 (OR调整1. 52) 和倾向匹配分析 (OR1. 20) 后,这种差异减弱且没有统计学意义.
  • 传统心肺复苏和只有压缩的心肺复苏均明显优于没有旁观者心肺复苏 (OR调整为5. 01和3. 29).

结论:

  • 在儿童OHCA中,传统的CPR和仅压缩的CPR都与没有旁观者CPR的结果有关.
  • 虽然未经调整的数据有利于传统的心肺复苏,但调整后的分析显示与仅压缩心肺复苏相比没有显著差异.
  • 需要进一步的随机试验,但在有比较数据之前,目前最好使用常规心肺复苏.