儿科心脏骤停后通风和氧化与生存结果的关联
Aisha H Frazier1,2, Alexis A Topjian3, Ron W Reeder4
1Nemours Cardiac Center, and.
Annals of the American Thoracic Society
|March 20, 2024
概括
心脏骤停后的低氧 (低氧) 和高头 (高二氧化碳) 与儿科患者的存活率下降有关. 过氧 (高氧) 和缺氧 (低二氧化碳) 对生存结果没有显著影响.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心肺复苏的结果心肺复苏.
- 逮捕后的生理管理
背景情况:
- 关于心脏骤停后氧气和二氧化碳水平对成人和儿科患者的结果的影响,存在相互矛盾的数据.
- 了解这些关联对于优化儿童复苏后护理至关重要.
研究的目的:
- 对儿科患者的逮捕后低氧化和高氧化与存活到出院的相关性进行调查.
- 确定在儿科患者中,逮捕后的低头和高头与存活到出院的时间之间的关联.
主要方法:
- 在多中心干预试验 (2016-2021) 中进行的前性观察性研究.
- 包括接受心脏骤停胸部压缩的儿科患者 (≤18岁).
- 定义和分析的暴露:低血 (<60 mmHg PaO2),高血 (≥200 mmHg PaO2),正常血 (60-199 mmHg PaO2),低头 (<30 mmHg PaCO2),高头 (≥50 mmHg PaCO2) 和正常头 (30-49 mmHg PaCO2) 在逮捕后24小时内.
- 使用波桑回归来评估与存活到出院的关联.
主要成果:
- 停药后的低氧化与医院出院的生存率显著降低相关 (调整后的相对风险[aRR] = 0.71;95% CI = 0.58-0.87).
- 停药后的头增大也与医院出院的生存率显著降低相关 (aRR = 0.74;95% CI = 0.64-0.84).
- 无论是高氧化还是低,与相应的正常氧化或正常相比,生存率都没有显著差异.
结论:
- 心脏骤停后的低氧和高头独立地与儿科患者的生存率下降有关.
- 这些发现凸显了儿童幸存者在逮捕后的时期维持诺尔莫克西米亚和诺尔莫卡普尼亚的重要性.
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