Survival probability in avalanche victims with long burial (>60 min): A retrospective study

RESUSCITATION

卷:166

Article

Eidenbenz, David^1,2  Techel, Frank³  Kottmann, Alexandre^3,4  Rousson, Valentin^4,5  Carron, Pierre-Nicolas^1,2  Albrecht, Roland^5,6  Pasquier, Mathieu^1,2 

[1] Univ Lausanne Hosp, Dept Emergency Med, Rue Bugnon 21,BH 09,CHUV, CH-1011 Lausanne, Switzerland

[2] Univ Lausanne, Rue Bugnon 21,BH 09,CHUV, CH-1011 Lausanne, Switzerland

[3] WSL Inst Snow & Avalanche Res SLF, Fluelastr 11, CH-7260 Davos, Switzerland

[4] Univ Lausanne Hosp, Swiss Air Ambulance Rega & Emergency Dept, POB 1414, CH-8058 Lausanne, Switzerland

[5] Ctr Primary Care & Publ Hlth Unisante prime, Route Berne 113, CH-1010 Lausanne, Switzerland

[6] Swiss Air Ambulance Rega, POB 1414, CH-8058 Zurich, Switzerland

关键词: Avalanche;    Cardiac arrest;    ECMO;    ECPR;    Hypothermia;    Accidental;    Resuscitation;    Triage;   

DOI  :  10.1016/j.resuscitation.2021.05.030

来源: Elsevier

【 摘 要 】

Background: The survival of completely buried victims in an avalanche mainly depends on burial duration. Knowledge is limited about survival probability after 60 min of complete burial. Aim: We aimed to study the survival probability and prehospital characteristics of avalanche victims with long burial durations. Methods: We retrospectively included all completely buried avalanche victims with a burial duration of >60 min between 1997 and 2018 in Switzerland. Data were extracted from the registry of the Swiss Institute for Snow and Avalanche Research and the prehospital medical records of the physician-staffed helicopter emergency medical services. Avalanche victims buried for >24 h or with an unknown survival status were excluded. Survival probability was estimated by using the non-parametric Ayer-Turnbull method and logistic regression. The primary outcome was survival probability. Results: We identified 140 avalanche victims with a burial duration of >60 min, of whom 27 (19%) survived. Survival probability shows a slight decrease with increasing burial duration (23% after 60 min, to <6% after 1400 min, p = 0.13). Burial depth was deeper for those who died (100 cm vs 70 cm, p = 0.008). None of the survivors sustained CA during the prehospital phase. Conclusions: The overall survival rate of 19% for completely buried avalanche victims with a long burial duration illustrates the importance of continuing rescue efforts. Avalanche victims in CA after long burial duration without obstructed airway, frozen body or obvious lethal trauma should be considered to be in hypothermic CA, with initiation of cardiopulmonary resuscitation and an evaluation for rewarming with extracorporeal life support.

【 授权许可】

Free