Survival in ventricular fibrillation with emphasis on the number of defibrillations in relation to other factors at resuscitation

被引：60

作者：

Holmen, Johan ^{[1
,2
]}

Hollenberg, Jacob ^{[3
]}

Claesson, Andreas ^{[3
]}

Jimenez Herrera, Maria ^{[4
]}

Azeli, Youcef ^{[5
]}

Herlitz, Johan ^{[6
,7
]}

Axelsson, Christer ^{[6
,7
]}

机构：

[1] Sahlgrens Univ Hosp, Dept Prehosp & Emergency Care, Dept Anesthesiol & Intens Care, Gothenburg, Sweden

[2] Sahlgrens Univ Hosp, Queen Silvia Childrens Hosp, Dept Pediat Anesthesia & Intens Care, Sweden Inst Med, Gothenburg, Sweden

[3] Karolinska Inst, Dept Med, Ctr Resuscitat Sci, Stockholm, Sweden

[4] Univ Rovira & Virgili, Dept Nursing, Tarragona, Spain

[5] Sistema Emergencies Med Catalunya, Lhospitalet De Llobregat, Spain

[6] Western Sweden Univ Coll Boras, Ctr Prehosp Res, Boras, Sweden

[7] Sahlgrens Univ Hosp, Inst Med, Gothenburg, Sweden

来源：

RESUSCITATION | 2017年 / 113卷

关键词：

Cardiac arrest; Resuscitation; Ventricular fibrillation; Defibrillation; Number of defibrillations; Survival in out of hospital cardiac arrest; HOSPITAL CARDIAC-ARREST; ADVANCED LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; SWEDEN; EXPERIENCE; CARE;

D O I：

10.1016/j.resuscitation.2017.01.006

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Introduction: Mortality after out of hospital cardiac arrest (OHCA) is high and a shockable rhythm is a key predictor of survival. A concomitant need for repeated shocks appears to be associated with less favorable outcome. Aim: To, among patients found in ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) describe: (a) factors associated with 30-day survival with emphasis on the number of defibrillatory shocks delivered; (b) the distribution of and the characteristics of patients in relation to the number of defibrillatory shocks that were delivered. Methods: Patients who were reported to The Swedish Register for Cardiopulmonary Resuscitation (SRCR) between January 1 1990 and December 31 2015 and who were found in VF/pVT took part in the survey. Results: In all there were 19,519 patients found in VF/pVT. The 30-day survival decreased with an increasing number of shocks among all patients regardless of witnessed status and regardless of time period in the survey. In a multivariate analysis there were 12 factors that were associated with the chance of 30-day survival one of which was the number of shocks that was delivered. For each shock that was added the chance of survival decreased. Factors associated with an increased 30-day survival included CPR before arrival of EMS, female sex, cardiac etiology and year of OHCA (increasing survival over years). Factors associated with a decreased chance of 30-day survival included: increasing age, OHCA at home, the use of adrenaline and intubation and an increased delay to CPR, defibrillation and EMS arrival. Conclusion: Among patients found in VF/pVT, 7.5% required more than 10 shocks. For each shock that was added the chance of 30-day survival decreased. There was an increase in 30-day survival over time regardless of the number of shocks. On top of the number of defibrillations, eleven further factors were associated with 30-day survival. (C) 2017 Elsevier B.V. All rights reserved.

引用

页码：33 / 38

页数：6

共 28 条

[1]

Ali A, 2013, J INVASIVE CARDIOL, V25, pE178

[2]

[Anonymous], 2016, SWEDISH CARDIAC ARRE

[3]

Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (PETCO2) during CPR in out-of-hospital cardiac arrest (OHCA) [J].