超声在心脏骤停患者心脏复苏中的预后价值

Ehsan Bolvardi, Seyyed Mohsen Pouryaghobi, Roohye Farzane, Niaz Mohammad Jafari Chokan, K. Ahmadi, H. Reihani
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引用次数: 12

摘要

心肺骤停是许多疾病的最终结果,因此,在这些情况下,需要仔细实施心肺复苏(CPR)方案是不可否认的重要。将超声波引入急诊科可能会在决定何时停止心肺复苏(CPR)时增加一个额外的数据点。本研究的目的是评估急诊医师进行心脏超声检查预测成人心脏骤停患者复苏结果的能力。在无脉性心脏骤停入院后立即对剑突下心脏区进行超声检查。超声心动图心脏活动被定义为任何可检测到的心脏运动,包括心房、心室或瓣膜。复苏成功定义为:恢复自主循环≥20min;呼吸的恢复;明显的脉冲;测量血压。本研究纳入159例患者。复苏开始时超声心动图心脏活动的存在与成功结局显著相关(复苏开始时无心脏活动的患者为41/49[83.7%],而复苏开始时无心脏活动的患者为15/110[13.6%])。超声检查心脏活动可能有助于确定心脏骤停的预后。超声对心脏骤停患者的预测价值有待进一步研究。
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The Prognostic Value of Using Ultrasonography in Cardiac Resuscitation of Patients with Cardiac Arrest
Cardiopulmonary arrest is the final result of many diseases and therefore, need for a careful implementation of cardiopulmonary resuscitation (CPR) protocols in these cases is undeniably important. The introduction of ultrasound into the emergency department has potentially allowed the addition of an extra data point in the decision about when to cease cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the ability of cardiac ultrasonography performed by emergency physicians to predict resuscitation outcome in adult cardiac arrest patients. Ultrasonographic examination of the subxiphoid cardiac area was made immediately after admission to the emergency department with pulseless cardiac arrest. Sonographic cardiac activity was defined as any detectable motion within the heart including the atria, ventricles or valves. Successful resuscitation was defined as: return of spontaneous circulation for ≥ 20 min; return of breathing; palpable pulse; measurable blood pressure. The present study includes 159 patients. The presence of sonographic cardiac activity at the beginning of resuscitation was significantly associated with a successful outcome (41/49 [83.7%] versus 15/110 [13.6%] patients without cardiac activity at the beginning of resuscitation). Ultrasonographic detection of cardiac activity may be useful in determining prognosis during cardiac arrest. Further studies are needed to elucidate the predictive value of ultrasonography in cardiac arrest patients.
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