紧急部门胸切除术:停止时间 - 一个创伤视频评论
Sriharsha Gummadi1, Shyam Murali2, Kristen Chreiman2
1Division of Traumatology, University of Pennsylvania, Surgical Critical Care and Emergency Surgery, Philadelphia, Pennsylvania; Division of Acute Care Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
The Journal of surgical research
|April 27, 2025
概括
长时间的急诊室胸切除术 (EDT) 复苏并没有改善创伤患者的生存率. 这项研究建议重新评估长时间EDT复苏工作的徒劳性,以获得更好的患者结果.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 进行心肺复苏术.
背景情况:
- 急诊室胸切除术 (EDT) 是为精选的创伤患者进行的一种拯救生命的手术,将他们连接到最终的手术修复.
- 与医疗心肺复苏相比,对创伤患者EDT的最佳复苏持续时间存在有限的指导.
- 这项研究研究了延长EDT复苏和持续恢复自发循环 (ROSC) 之间的关联.
研究的目的:
- 为了确定长时间的急诊室胸切除术 (EDT) 复苏工作是否与创伤患者的自发循环 (ROSC) 的持久恢复有关.
- 评估延长复苏时间在实现持续的ROSC和在手术室修复后的存活率方面的有效性.
主要方法:
- 从一级创伤中心 (2022年1月至2023年1月) 的创伤室视频和电子医疗数据的回顾性审查.
- 包括接受EDT的患者,不包括那些视频数据不足的患者,18岁以下的患者,囚犯或孕妇.
- 复苏持续时间被定义为从EDT切口到ROSC或死亡判决的时间.
主要成果:
- 在41名患者中,有7名患者 (39名枪伤,2名伤) 在EDT后获得了ROSC.
- 在获得持久ROSC的患者和没有获得持久ROSC的患者之间,没有观察到切口时间或复苏持续时间的显著差异.
- 在20分钟的复苏后,没有持续的ROSC;只有两个持久ROSC的患者存活到出院,两人都在神经上完好无损,并在10分钟内实现ROSC.
结论:
- 在急诊室胸切除术 (EDT) 期间延长的复苏时间与创伤患者自发循环 (ROSC) 持久恢复率的增加无关.
- 延长EDT复苏努力应促使对徒劳性进行批判性重新评估,以优化患者护理和资源配置.
- 这些发现表明,需要修订有关创伤环境中EDT复苏持续时间的协议.
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