在医院内心脏病停顿:一篇综述
Lars W Andersen1,2,3, Mathias J Holmberg1,2, Katherine M Berg2,4
1Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
JAMA
|March 27, 2019
概括
医院内心脏骤停每年影响近30万美国成年人,但支持临床决策的研究仍然有限. 提高意识和进一步研究对于改善心脏骤停治疗的患者结果至关重要.
科学领域:
- 心脏病学
- 危急护理医学
- 紧急医疗
背景情况:
- 住院心脏骤停 (IHCA) 是一个普遍的医疗紧急情况,死亡率很高.
- 与其他心血管紧急情况 (如中风或心肌梗塞) 相比,IHCA受到了较少的研究关注.
- 在美国,每年发生超过29万例成人IHCA事件.
研究的目的:
- 突出医院内心脏骤停 (IHCA) 的重要性.
- 审查目前对IHCA流行病学,原因和管理的理解.
- 强调需要改善IHCA的临床决策和研究.
主要方法:
- 对美国IHCA人口统计和呈现节奏的队列数据的分析
- 对心脏骤停,包括胸部压缩,通风和除治疗的既定治疗方案的审查.
- 讨论心脏骤停后的护理策略和预后因素.
主要成果:
- IHCA患者的平均年龄为66岁,58%为男性.
- 大多数IHCA病例 (81%) 呈现出不可震动的节律 (失速或无脉动电活动).
- 心脏 (50% - 60%) 和呼吸不全 (15% - 40%) 是最常见的IHCA原因.
结论:
- 尽管IHCA的发病率很高,但支持临床决策的证据有限.
- 预测和指导心脏骤停后的临床决策需要采用多方面的方法.
- 提高认识,优化临床护理和进一步研究对于改善IHCA结果至关重要.
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