梅奥注册中心在心脏骤停研究中的遥测疗效:评估不插管码状态的可行性。

Acute cardiac care Pub Date : 2016-12-01 Epub Date: 2017-12-06 DOI:10.1080/17482941.2017.1408917
David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton
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引用次数: 1

摘要

导言:指南建议在入院时与患者讨论代码状态。没有研究评估了不插管(DNI)状态下完整代码的可行性。方法:回顾性分析2008年5月1日至2014年6月20日期间发生心肺骤停的患者。基于患者在住院期间是否需要机械通气支持进行描述性分析,并对两组患者进行比较。结果:共纳入239例患者。几乎所有患者(n = 218, 91.2%)在住院期间都需要插管。超过半数(117例,53.7%)患者在心肺骤停当天插管,91例(41.7%)患者在心肺骤停时插管。插管和非插管患者的临床特征比较差异不大,除了不需要插管的患者入院时医学心脏病因的比例更高(n = 10, 47.6% vs n = 55, 25.2%;P = 0.18)和室性心动过速/颤动的初始骤停节律(n = 8, 38.1% vs n = 50, 22.9%;p = 0.37)。24小时生存率和出院后生存率无差异。结论:机械通气支持常用于心肺骤停患者。对于大多数患者来说,DNI状态可能不是一个可行的代码状态选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status.

Introduction: Guidelines recommend discussing code status with patients on hospital admission. No study has evaluated the feasibility of a full code with do not intubate (DNI) status. Methods: A retrospective analysis of patients who experienced a cardiopulmonary arrest was performed between May 1, 2008 and June 20, 2014. A descriptive analysis was created based on whether patients required mechanical ventilatory support during the hospitalization and comparisons were made between both patient subsets. Results: A total of 239 patients were included. Almost all (n = 218, 91.2%) required intubation during the hospitalization. Over half (n = 117, 53.7%) were intubated on the same day as the cardiopulmonary arrest and 91 patients (41.7%) were intubated at the time of arrest. Comparisons between intubated and non-intubated patients showed little differences in clinical characteristics, except for a higher proportion of medical cardiac etiology for admission in patients who did not require intubation (n = 10, 47.6% versus n = 55, 25.2%; p = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; = 0.37). No differences in 24-hour and posthospital survivals were present. Conclusion: Mechanical ventilatory support is commonly utilized in patients who experience a cardiopulmonary arrest. The DNI status may not be a feasible code status option for most patients.

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