儿科急诊室心肺复苏8年经验.docVIP

PROGNOSIS OF CARDIOPULMONARY RESUSCITATION IN A PEDIATRIC HOSPITAL EMRGENCY DEPARTMENT Kuang Fengwu, Zhao Ping, Deng Yaobi , Division of Pediatric critical care Children’s Hospital, Chongqing University of Medical Sciences. 4000l4, P. R. China Objective: To determine the effectiveness of cardiopulmonary resuscitation(CPR) in the emergency department (ED) and the factors associated with outcome. Method: We conducted a retrospective review of prospective1y collected CPR data in a 13 million metropolitan city served by a single childrens hospital between January 1, 1993 and December 31, 2000. Results: A total of 399 children suffering from cardiopulmonary arrest were sent to the ED and advanced life support was attempted. Among them, profound bradycardia-arrest was recorded in 191 cases, ventricular fibrillation was recorded in 3 cases and all three had heart problems. 205 cases had prehospital heart arrest and the duration of cardiac arrest was unknown. They had neither heart beat nor breath when arrived at the Emergency department, the Dead-On-Arrivals(DOA). 252 cases were intubated during CPR. After advanced life support, 182 children demonstrated return of spontaneous circu1ation and hospitalized. 155 out of 194 (79.9%) ED-witnessed cardiac arrests were successfully resuscitated. Only 27 out of 205( 13.2% ) DOAs were successfully resuscitated and 23 of them were neonates. 130 out of 229 ( 43.7% )neonates, 30 out of 71 ( 42.3% )from 1 mo to 5mos old infants, 22 out of 99( 22.2% ) beyond 6mos old children were successfully resuscitated. There was no statistical deference of successful resuscitation rate between neonates and 1mo to 5mos old infants(p0.05). The successful resuscitation rate of neonates or 1mo to 5mos old infants was significantly higher than that of beyond 6mos old children(p0.001). The successful resuscitation rate of ED-witnessed cadiac arrest was significantly higher than that of DOAs(p0.001). The successful resuscitation rate of was significa