在非创伤性OHCA中,乳酸值可以预测CPR期间自发循环的恢复吗?
J Contenti1, C Occelli1, A Lemachatti1
1Department of Emergency Medicine, Hospital Pasteur, 2 - 30, avenue de la voie Romaine, F06100 Nice, France; University of Nice Sophia Antipolis, School of Medicine, Avenue de Valombrose, F06100 Nice, France.
The American journal of emergency medicine
|February 22, 2024
概括
在心肺复苏 (CPR) 期间的血中乳酸水平不能预测在非医院心脏骤停中自发心脏活动 (ROSC) 的恢复. 然而,在ROSC后的乳酸变化可能表明这些患者的生存率.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
背景情况:
- 心脏骤停是一个重大的公共卫生问题.
- 紧急医疗服务 (EMS) 在50-60%的病例中启动或继续复苏.
- 确定恢复自发心脏活动 (ROSC) 的预后指标至关重要.
研究的目的:
- 调查血液中乳酸盐水平及其在心肺复苏 (CPR) 期间的变化是否可以预测非创伤性医院外心脏骤停 (OHCA) 的ROSC.
主要方法:
- 展望性,干预性,多中心研究 (2017-2020).
- 包括非创伤性OHCA需要CPR的成年患者.
- 测量了初始静脉和毛细血管乳酸,以及随后的毛细血管乳酸在心肺复苏期间使用点护理设备.
主要成果:
- 在ROSC和没有ROSC的患者之间,初始乳酸盐水平没有显著差异.
- 最初的静脉乳酸中位数为6.2 mmol/L.
- 最初的潮尾CO2,可冲击的节奏和ROSC前的上腺素剂量独立地与ROSC相关.
结论:
- 在心肺复苏期间的血乳酸水平不是非创伤性OHCA中ROSC的独立预测指标.
- 在前30分钟内ROSC后的乳酸动力学可能与生存有关.
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