小儿心肺复苏:阿曼某三级专科医院急诊科与住院患者的比较

Shilpa Ramachandran, Niranjan Lal, S. Panchatcharam, Marwan Al Raisi, S. Abri
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引用次数: 0

摘要

目的:本研究的目的是比较苏丹卡布斯大学医院(SQUH)急诊科(ED)和住院患者的心肺复苏(CPR)。方法:对2012年1月至2017年8月苏丹卡布斯大学医院(susultan Qaboos University Hospital, SQUH)儿科心肺复苏术进行回顾性队列分析。对心肺复苏术单进行了四个主要变量的审查:患者相关、事件相关、治疗和结果。结果:共纳入83例,其中男性48例(58%),女性35例(42%)。2 / 3的患者(n=56)住院;而三分之一的病例来自ED (n=27)。总的来说,呼吸骤停是最常见的原因,占73.5% (n=61)。事件在较年轻的年龄组中更为常见,50%在不到1年的时间内发生(n=41)。心动过缓伴低灌注型占骤停型的65% (n=54),其次是骤停型的31% (n=26)。只有10%的患者存活至出院(n=8)。相比之下,89%的急诊科逮捕是无人目击的。另一方面,PICU和病房骤停主要监测98% (n=55)。ED患者在骤停后24小时内的生存率为19.2% (n=5), 1年内的生存率为11.5% (n=3),而PICU/Ward患者在骤停后24小时和1年内的生存率为8.9% (n=5),但差异无统计学意义。结论:急诊和住院心肺骤停患者的复苏生存结果几乎相似,尽管在变量上没有显著差异。总体而言,10%的患者存活至出院,较高的生存率与CPR持续时间少于20分钟有关。骨内通路未得到充分利用,应尽早应用,特别是在急诊科,以防止延迟复苏药物的施用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pediatric cardiopulmonary resuscitation: comparison between emergency department and inpatients setting at a tertiary academic hospital in Oman
Objective: The aim of this study was to compare cardiopulmonary resuscitation (CPR) between emergency department (ED) and inpatients setting at Sultan Qaboos University Hospital (SQUH). Methods: The study was a retrospective cohort chart review of pediatric CPR at Sultan Qaboos University Hospital (SQUH) from January 2012 till August 2017. The CPR sheets were reviewed for four main variables: patient related, event related, treatment and outcomes. Results: A total of 83 cases were included, 48 males (58%) and 35 females (42%). Two Thirds of the patients (n=56) were in-patient; whereas one third of cases were from ED (n=27). Overall, most common cause for arrest that accounted 73.5% (n=61) was due to respiratory arrest. Events were more common in younger age group with 50% in less than 1 year (n=41). Bradycardia with hypo-perfusion represented most of arrest type 65% (n=54) followed by asystole 31% (n=26). Only 10% of patient survived to discharge (n=8). In comparison, 89% of ED arrest were unwitnessed. On the other hand, PICU and ward arrests predominantly were monitored 98% (n=55). ED patients’ survival appeared better at 19.2% (n=5) within 24hrs post arrest and 11.5% (n=3) within 1-year in comparison to PICU/Ward of 8.9% (n=5) survival within 24hrs and 1-year post event yet it was not statistically significant. Conclusion: The survival outcome in resuscitation was almost similar between ED & In-patient setting (PICU/wards) cardiopulmonary arrests despite having few significant differences based on variables. Overall, 10% of patients survived to discharge and higher survival rates are associated with duration of CPR less than 20 minutes . Intraosseous route is underutilized and should be applied earlier especially in ED to prevent delay in administration of resuscitation medications.
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