Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52...Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.展开更多
目的综合评价喉罩通气与面罩通气对院外心脏骤停(out of hospital cardialc arrest,OHCA)患者急救复苏的效果。方法采用Meta分析方法制定原始文献的纳入标准、排除标准及检索策略,检索多个中英文文摘型数据库及全文数据库,获得喉罩通气...目的综合评价喉罩通气与面罩通气对院外心脏骤停(out of hospital cardialc arrest,OHCA)患者急救复苏的效果。方法采用Meta分析方法制定原始文献的纳入标准、排除标准及检索策略,检索多个中英文文摘型数据库及全文数据库,获得喉罩通气与面罩通气前瞻性和回顾性研究,进行文献质量评价后,应用Rev Man 5.3分析软件进行敏感性和异质性分析,并采用固定效应或随机效应模型计算合并后的综合效应。结果共纳入9篇病例对照研究,Meta分析结果显示,排除异质性,喉罩通气较面罩通气具有较高的院外心脏骤停(OHCA)患者复苏成功率(OR=2.28,95%CI1.74-2.99Z=5.97,P<0.01),但对复苏成功后1个月生存率、复苏成功率及神经系统功能恢复方面的影响效果无统计学意义(P>0.05)。结论喉罩通气具有更高的院外心脏骤停患者复苏成功率,但对远期效果生存几率及神经系统的改善情况还需要大样本、多中心RCT研究有待进一步验证。展开更多
目的系统评价体外序贯双除颤(DSED)对顽固性室颤患者自主循环恢复(ROSC)的影响。方法检索中英文数据库Web of science、EMBASE、Medline及万方数据库、中国学术期刊全文数据库、中国生物医学文献数据库等,筛选发表至2022年3月的顽固性...目的系统评价体外序贯双除颤(DSED)对顽固性室颤患者自主循环恢复(ROSC)的影响。方法检索中英文数据库Web of science、EMBASE、Medline及万方数据库、中国学术期刊全文数据库、中国生物医学文献数据库等,筛选发表至2022年3月的顽固性室颤使用DSED的观察性研究和随机对照研究。结果共纳入5篇文献,其中1篇为随机对照研究,4篇为观察性研究。纳入1152例院外心脏骤停(out-of hospital cardiac arrest,OHCA)顽固性室颤患者,其中272例接受DSED,880例接受标准除颤。DSED组和标准除颤组患者ROSC分别为33.1%和39.0%,OR=0.75(95%CI 0.55~1.01,P=0.06),室颤终止分别为51.5%和53.6%,OR=0.74(95%CI 0.55~1.00,P=0.05)。两组患者入院时存活率和出院时存活率差异无统计学意义。结论DSED未增加顽固性室颤患者ROSC成功率。展开更多
Introduction: Little is known about discrepancies between patients who present with or without STEMI following out-of-hospital cardiac arrest (OHCA). Material and Methods: All patients with OHCA who were admitted to o...Introduction: Little is known about discrepancies between patients who present with or without STEMI following out-of-hospital cardiac arrest (OHCA). Material and Methods: All patients with OHCA who were admitted to our hospital between January 1st 2008 and December 31st 2013 were classified according to their initial laboratory and electrocardiographic findings into STEMI, NSTEMI or no ACS. Results: Overall, 147 patients [32 STEMI (21.8%), 28 NSTEMI (19.0%) and 87 no ACS (59.2%)] were included with a mean age of 63.7 ± 13.3 years;there were 84 men (57.1%) and 63 (42.9%) women. Of these, 63 patients (51.7%) received coronary angiography [29 STEMI (90.6%), 9 NSTEMI (32.1%) and 38 no ACS (43.7%)] showing a high prevalence of coronary artery disease (CAD) [28 STEMI (96.6%), 9 NSTEMI (100.0%) and 26 no ACS (68.4%)] requiring percutaneous coronary intervention (PCI) in 52 cases [28 STEMI (96.6%), 8 NSTEMI (88.9%) and 16 no ACS (42.1%)]. Discussion: Coronary angiography immediately after hospital admission is feasible if all are prepared for potential further resuscitation efforts during cardiac catheterization. Primary focus on haemodynamic stabilisation may reduce the rates of coronary angiographies in patients following OHCA. Altogether, our data support the call for immediate coronary angiography in all patients following OHCA irrespective of their initial laboratory or electrocardiographic findings.展开更多
文摘Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.
文摘目的综合评价喉罩通气与面罩通气对院外心脏骤停(out of hospital cardialc arrest,OHCA)患者急救复苏的效果。方法采用Meta分析方法制定原始文献的纳入标准、排除标准及检索策略,检索多个中英文文摘型数据库及全文数据库,获得喉罩通气与面罩通气前瞻性和回顾性研究,进行文献质量评价后,应用Rev Man 5.3分析软件进行敏感性和异质性分析,并采用固定效应或随机效应模型计算合并后的综合效应。结果共纳入9篇病例对照研究,Meta分析结果显示,排除异质性,喉罩通气较面罩通气具有较高的院外心脏骤停(OHCA)患者复苏成功率(OR=2.28,95%CI1.74-2.99Z=5.97,P<0.01),但对复苏成功后1个月生存率、复苏成功率及神经系统功能恢复方面的影响效果无统计学意义(P>0.05)。结论喉罩通气具有更高的院外心脏骤停患者复苏成功率,但对远期效果生存几率及神经系统的改善情况还需要大样本、多中心RCT研究有待进一步验证。
文摘Introduction: Little is known about discrepancies between patients who present with or without STEMI following out-of-hospital cardiac arrest (OHCA). Material and Methods: All patients with OHCA who were admitted to our hospital between January 1st 2008 and December 31st 2013 were classified according to their initial laboratory and electrocardiographic findings into STEMI, NSTEMI or no ACS. Results: Overall, 147 patients [32 STEMI (21.8%), 28 NSTEMI (19.0%) and 87 no ACS (59.2%)] were included with a mean age of 63.7 ± 13.3 years;there were 84 men (57.1%) and 63 (42.9%) women. Of these, 63 patients (51.7%) received coronary angiography [29 STEMI (90.6%), 9 NSTEMI (32.1%) and 38 no ACS (43.7%)] showing a high prevalence of coronary artery disease (CAD) [28 STEMI (96.6%), 9 NSTEMI (100.0%) and 26 no ACS (68.4%)] requiring percutaneous coronary intervention (PCI) in 52 cases [28 STEMI (96.6%), 8 NSTEMI (88.9%) and 16 no ACS (42.1%)]. Discussion: Coronary angiography immediately after hospital admission is feasible if all are prepared for potential further resuscitation efforts during cardiac catheterization. Primary focus on haemodynamic stabilisation may reduce the rates of coronary angiographies in patients following OHCA. Altogether, our data support the call for immediate coronary angiography in all patients following OHCA irrespective of their initial laboratory or electrocardiographic findings.
