心肺复苏时间和生存关系.pptVIP

Duration of resuscitation efforts and survival afterin-hospital cardiac arrest: an observational study Introduction Between 1-5 of every 1000 hospital inpatients in developed countries are estimated to have a cardiac arrest, and less than 20% of such patients survive to discharge. We assessed patterns of duration of resuscitation attempts and risk-adjusted survival at US hospitals. Methods Between 2000 and 2008, we identified 64 339 patients with cardiac arrests at 435 US hospitals within the Get With The Guidelines—Resuscitation registry. For each hospital, we calculated the median duration of resuscitation before termination of efforts in non-survivors as a measure of the hospital’s overall tendency for longer attempts. We used multilevel regression models to assess the association between the length of resuscitation attempts and risk adjusted survival. Our primary endpoints were immediate survival with return of spontaneous circulation during cardiac arrest and survival to hospital discharge. Results 12924 (20·1%) ventricular tachycardia or fibrillation 51415 (79·9%) pulseless electrical activity or asystole 31198 (48·5%) patients achieved return of spontaneous circulation 9912 (15·4%) survived to discharge. Mean length of stay in hospital was 8.3 d Patients survived to discharge with a mean hospital stay 16.6 d Results Median duration of resuscitation was 17min For patients achieving return of spontaneous circulation, the median duration of resuscitation was 12 min compared with 20 min for non-survivors. Compared with patients at hospitals in the quartile with the shortest median resuscitation attempts in non-survivors (16 min), those at hospitals in the quartile with the longest attempts (25 min) had a higher likelihood of return of spontaneous circulation Results 80.6%who survived to discharge and had a favourable neurological status Neurological status in survivors to discharge did not significantly differ on the basis of resuscitation du