Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study

RESUSCITATION

卷:130

Article

Yates, E. J.¹  Schmidbauer, S.^2,3  Smyth, A. M.^4,5  Ward, M.⁵  Dorrian, S.⁶  Siriwardena, A. N.⁷  Friberg, H.^2,3  Perkins, G. D.¹ 

[1] Univ Hosp Birmingham NHS Fdn Trust, Heartlands Hosp, Crit Care Unit, Birmingham, W Midlands, England

[2] Lund Univ, Skane Univ Hosp, Dept Clin Sci Anaesthesiol & Intens Care, Malmo, Sweden

[3] Lund Univ, Ctr Cardiac Arrest, Lund, Sweden

[4] Univ Warwick, Warwick Clin Trials Unit, Coventry, W Midlands, England

[5] West Midlands Ambulance Serv NHS Fdn Trust, Birmingham, W Midlands, England

[6] Univ Hosp Birmingham NHS Fdn Trust, Dept Emergency Med, Birmingham, W Midlands, England

[7] Univ Lincoln, Sch Hlth & Social Care, Coll Social Sci, Community & Hlth Res Unit, Lincoln, England

关键词: Cardiac arrest;    Out-of-hospital cardiac arrest;    OHCA;    Cardiopulmonary resuscitation;    CPR;    Termination of resuscitation;    TOR;    Ongoing CPR, observational;    Universal prehospital termination of resuscitation rule;    Return of spontaneous circulation;    ROSC;    Survival to discharge;    West Midlands;    UK;    Decision support techniques;   

DOI  :  10.1016/j.resuscitation.2018.06.021

来源: Elsevier

【 摘 要 】

Introduction: Termination of resuscitation guidelines for out-of-hospital cardiac arrest can identify patients in whom continuing resuscitation has little chance of success. This study examined the outcomes of patients transferred to hospital with ongoing CPR. It assessed outcomes for those who would have met the universal prehospital termination of resuscitation criteria (no shocks administered, unwitnessed by emergency medical services, no return of spontaneous circulation). Methods: A retrospective cohort study of consecutive adult patients who were transported to hospital with ongoing CPR was conducted at three hospitals in the West Midlands, UK between September 2016 and November 2017. Patient characteristics, interventions and response to treatment (ROSC, survival to discharge) were identified. Results: 227 (median age 69 years, 67.8% male) patients were identified. 89 (39.2%) met the universal prehospital termination of resuscitation criteria. Seven (3.1%) were identified with a potentially reversible cause of cardiac arrest. After hospital arrival, patients received few specialist interventions that were not available in the prehospital setting. Most (n= 210, 92.5%) died in the emergency department. 17 were admitted (14 to intensive care), of which 3 (1.3%) survived to hospital discharge. There were no survivors (0%) in those who met the criteria for universal prehospital termination of resuscitation. Conclusion: Overall survival amongst patients transported to hospital with ongoing CPR was very poor. Application of the universal prehospital termination of resuscitation rule, in patients without obvious reversible causes of cardiac arrest, would have allowed resuscitation to have been discontinued at the scene for 39.2% of patients who did not survive.

【 授权许可】

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