David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton
{"title":"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。","authors":"David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton","doi":"10.1080/17482941.2017.1408917","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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%; <i>p</i> = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; <i>p </i>= 0.37). No differences in 24-hour and posthospital survivals were present. <b>Conclusion:</b> 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.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 4","pages":"79-84"},"PeriodicalIF":0.0000,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1408917","citationCount":"1","resultStr":"{\"title\":\"Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status.\",\"authors\":\"David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton\",\"doi\":\"10.1080/17482941.2017.1408917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Introduction:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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%; <i>p</i> = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; <i>p </i>= 0.37). No differences in 24-hour and posthospital survivals were present. <b>Conclusion:</b> 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.</p>\",\"PeriodicalId\":87385,\"journal\":{\"name\":\"Acute cardiac care\",\"volume\":\"18 4\",\"pages\":\"79-84\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1080/17482941.2017.1408917\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acute cardiac care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/17482941.2017.1408917\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/12/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute cardiac care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17482941.2017.1408917","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/12/6 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
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。
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%; p = 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.