Analysis of the characteristics of brain resuscitation in patients with out-of-hospital cardiac arrest after resuscitation
Objective Toanalyze and discuss the characteristics of cardiopulmonary and cerebral resuscitation(CPCR)in patients after out-of-hospital cardiac arrest(OHCA).Methods The data of OHCA patients admitted to the directly-managed branch of the Wuxi Emergency Medical Center,covering the period from December 26,2016,at 7:45 to August 26,2022,at 7:45.The analysis included the first electrocardiogram(ECG),clinical characteristics,pre-hospital emergency measures,and follow-up conditions in the hospital.Based on the Glasgow-Pittsburgh cerebral function grading at discharge,patients were divided into a CPCR group(grades 1-2)and a non-CPCR group(grades 3-5).The study compared the basic conditions,resuscitation times,and vital signs after resuscitation between the two groups to evaluate the factors affecting CPCR.Results A total of 6 040 OHCA cases were treated,3 002 cases received pre-hospital resuscitation.The initial ECG indicated a shockable rhythm in 185 cases,with a shockable rhythm rate of 6.16％.There were 293 pre-hospital survivors,with a pre-hospital survival rate of 9.76％.170 cases survived to be discharged,with a discharge survival rate of 5.66％.Ultimately,44 cases achieved CPCR,accounting for 25.88％of the cases that survived to discharge.There were statistically significant differences in terms of first-witness treatment,defibrillable rhythm ratio,defibrillation,response to pain stimulation after return of spontaneous circulation(ROSC),spontaneous breathing,light reflex,pulse oxygenation,and blood pressure between the CPCR and non-CPCR groups(all P＜0.05).The CPCR group showed significantly higher proportions than the non-CPCR group in the defibrillatable rhythm(75.00％vs.10.44％),undergoing defibrillation(70.46％vs.9.24％),having spontaneous breathing after ROSC(86.36％vs.17.27％),and having oxygen saturation＞92％with systolic blood pressure＞90 mmHg(86.36％vs.39.76％).There were statistically significant differences between the CPCR and non-CPCR groups in the time from cardiac arrest(CA)to doctor reception,CA to first defibrillation,CA to ROSC,and CA to discharge or in-hospital death(all P＜0.05).Conclusions The patients with successful pre-hospital resuscitation and finally cerebral resuscitation were characterized by short times from OHCA to first medical contact(FMC)and from FMC to ROSC,appropriate pre-hospital vital sign management accompanied by partial neurological recovery,and comprehensive in-hospital neurological prognosis assessment.
Out-of-hospital cardiac arrestCardiopulmonary and cerebral resuscitationPre-hospital carePre-hospital survivalFirst medical contact
万方数据
维普
