在重症监护运输中的心脏骤停:一个病例控制研究
Elizabeth Kadow1, Yixin Kong2, Jason E Cohen3
1Boston MedFlight, 150 Hanscom Dr, Bedford, MA 01730, USA; Brown Emergency Medicine, Rhode Island Hospital, 55 Claverick Street, 2nd Floor, Providence, RI 02903, USA.
The American journal of emergency medicine
|April 9, 2025
概括
运输期间的临床恶化是一个已知的风险. 这项研究确定了运输方式,血管压缩剂的使用和初始血压作为关键因素与心脏骤停相关的关键护理运输. 自发循环的回归是低的.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 运输医学 运输医学
背景情况:
- 临床恶化和失补偿是患者移动和运输期间的已知风险,特别是在重症患者身上.
- 患者的敏度与运输过程中脱补偿的风险和潜在后果直接相关.
研究的目的:
- 在接受重症监护运输 (CCT) 的患者中确定与心脏骤停相关的因素.
- 分析在CCT期间心脏骤停的患者的结果.
主要方法:
- 在2020年10月至2022年9月期间,在CCT团队到达后经历心脏骤停的患者进行了一项描述性和病例控制研究.
- 纳入标准侧重于在CCT团队到达后被逮捕的患者;排除包括现场运输,儿科患者,以及未在路上被逮捕或未被运输的患者.
主要成果:
- 在两年内,87名患者 (0.7%) 经历了CCT到达后的心脏骤停,常见的运输指示包括严重创伤,呼吸停止和大动脉紧急情况.
- 病例对照分析显示,心脏骤停和运输方式 (OR 2.66),血管压缩剂数量 (OR 从3.46到16.0不等),以及初始平均动脉压 (MAP) 和静脉血压 (SBP) (OR 0.98两者) 之间存在关联.
- 在32名在运输中被停留的患者中,只有15人 (46.9%) 恢复了自发循环 (ROSC).
结论:
- 运输方式,血管压缩剂的使用,以及最初的MAP和SBP是与CCT期间心脏骤停相关的重要变量.
- 尽管心脏骤停的发生不常见,但ROSC的发生率仍然很低,为46.9%.
- 需要进一步的研究来确定在运输过程中患者被逮捕的风险值.
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