脑复苏集般束化治疗策略.pptVIP

* Incidence of iatrogenic dyscarbia during therapeutic hypothermia after successful resuscitation from out-of-hospital cardiac arrest 院外心脏骤停成功复苏后的低体温疗法过程中医源性异常碳酸血症的发生率 PaCO2 of 122 pts 1627 measurements 图中35-45mmHg（4.6-6KPa） In the multicenter patient population of 122 patients contributing a total of 1627 measurements, the PaCO(2) distribution was as follows: less than 4 kPa in 148 samples out of 1627 (9%), 4-4.6 kPa in 404 (25%), 4.7-6 kPa in 887 (55%) and more than 6 kPa in 188 samples (12%). There was a significant difference in the incidence of hypercarbia between the hospitals (p0.05).We conclude that normocarbia was achieved/maintained only in approximately 55% of the samples. The incidence of hypo- or hyper-carbia (dyscarbia) was high (45%). This may predispose for serious derangements in the cerebral perfusion of the resuscitated patient. These results call for vigilance in adjustment of the ventilatory management to meet the needs of the patients treated with mild hypothermia. * Incidence of iatrogenic dyscarbia during therapeutic hypothermia after successful resuscitation from out-of-hospital cardiac arrest 院外心脏骤停复苏后低温疗法下医源性异常碳酸血症的发生率 Retrospective cohort study of the ventilatory management based on blood gas analyses of patients resuscitated from prehospital cardiac arrest. In the pilot phase, we assessed the ventilatory management in the patients treated in one university hospital during a 4-year study period. Subsequently, a more recent (1-year) retrospective cohort of resuscitated patients from all five Finnish university hospitals concerning the first 48h after hospital admission was analyzed. Core temperatures and temperature corrected (or non-corrected) blood gas analysis results with focus on carbon dioxide tension were analyzed. In addition, a survey was performed to investigate the ventilatory strategies in all Finnish hospitals providing mild hypothermia for cardiac arrest victims A high incidence of hypo- or hyper-carbia during hypother