在心脏骤停期间通过心声成像图可视化的隐性心室动:来自超声波结果网络 (REASON) 实时评估和评估的回顾性观察研究
Romolo Gaspari1, Srikar Adhikari2, Timothy Gleeson1
1Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
医院外心脏骤停患者在心电图上有时有非可震动的节奏,在心电图上有时有心室动 (VF). 识别这种隐藏的VF可以通过迅速除来提高生存率.
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:
- 与可震动节律相比,非可震动节律的患者在医院外心脏骤停 (OHCA) 的存活率显著较低.
- 电心电图 (ECG) 是识别可震动节律的标准,但它可能错过了心室动 (VF) 的病例.
研究的目的:
- 为了确定隐性心室 (VF) 的患病率在OHCA患者呈现非震动节律,通过心声学检测.
- 评估识别隐性VF对治疗策略和患者结果的潜在影响.
主要方法:
- 从REASON多中心观察性研究中对OHCA患者具有非震动节律的回声图像 (回声) 的二次分析.
- 两个独立的急诊医生在心肺复苏 (CPR) 暂停期间审查了心电图和回声图像,以确定隐藏的VF.
- 如果有必要,使用第三位医生的判断;心电图解释是不盲目的.
主要成果:
- 隐性VF在3.2% (22/685) 的OHCA患者中被发现,在第一个心肺复苏暂停期间,他们的节律不能受到冲击.
- 患有心电图诊断VF的患者 (n=55) 获得了立即除,而患有隐性VF的患者没有.
- 在患有隐性VF的患者中,当VF在随后的心电图上被识别时,50% (11/22) 最终被除.
结论:
- 大约33个OHCA患者中的1个具有不可冲击的心电图节奏实际上在心声图上表现出VF.
- 在急诊室通过心声学检测发现的隐性VF的及时识别和除可能会改善OHCA患者的治疗结果.
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