在医院心脏骤停期间无脉动的电活动和心脏骤停:解开"不可震动"的节奏
Luke Andrea1, Ariel L Shiloh1, Mai Colvin1
1Montefiore Medical Center, Department of Critical Care Medicine, 111 E 210th St, Bronx, NY 10467, United States.
Resuscitation
|June 3, 2023
概括
无脉动电活动 (PEA) 和心动静止是医院内不同的心脏骤停节奏. 虽然PEA具有更高的自发循环回归 (ROSC) 率,但这两个节奏都不会影响到出院的生存率.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 关键护理医学 关键护理医学
背景情况:
- 在美国,无脉动电活动 (PEA) 和心脏衰竭 (asystole) 占初始住院心脏骤停 (IHCA) 节律的81%.
- 这些不可冲击的节奏通常是集体研究和管理的.
- 这项研究调查了PEA和 asystole是否代表具有独特特征的独特IHCA节奏.
研究的目的:
- 为了比较无脉动电活动 (PEA) 和心动静止作为初始住院心脏骤停 (IHCA) 节奏.
- 为了确定PEA和 asystole之间的逮捕前特征,复苏实践和患者结局的区分特征.
主要方法:
- 使用Get With The Guidelines®-复苏注册 (2006-2019) 的观察队列研究.
- 包括IHCA指数和PEA或 asystole的初始节奏的成年患者.
- 比较PEA与 asystole组在逮捕前的因素,复苏干预和结果方面.
主要成果:
- 确定了147,377例PEA和79,720例心性IHCA病例.
- 在非远程测量病房中,血压硬化发生的频率更高 (22.1%对13.9%).
- PEA显示ROSC的调整后几率更高 (61.8%与56.4%),但在存活到出院的时间没有显著差异 (19.1%与18.7%).
- 当ROSC没有实现时,对 asystole 的复苏持续时间更短.
结论:
- 患有初始PEA节律的患者在患者因子和复苏管理方面与患有 asystole 患者有所不同.
- 在监控环境中,PEA逮捕更常见,并且接受了更长时间的复苏.
- 尽管PEA的ROSC率较高,但两组患者的存活到出院的时间仍然相似.
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