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Prognostic factors associated with hospital survival in comatose survivors of cardiac arrest

World Journal of Critical Care Medicine 2016年第1期5卷 103-110页

作者： kushaharan sathianathan Ravindranath Tiruvoipati Sanjiv Vij Critical Care Unit Latrobe Regional Hospital Department of Intensive Care Medicine Frankston Hospital School of Public Health Faculty of Medicine Nursing and Health Sciences Monash University Intensive Care Unit Dandenong Hospital Intensive Care Unit Royal Melbourne Hospital

AIM: To identify patient, cardiac arrest and management factors associated with hospital survival in comatose survivors of cardiac ***: A retrospective, single centre study of comatose patients admitted to our intensive care unit(ICU) following cardiac arrest during the twenty year period between 1993 and 2012. This study was deemed by the Human Research Ethics Committee(HREC) of Monash Health to be a quality assurance exercise, and thus did not require submission to the Monash Health HREC(Research Project Application, No. 13290Q). The study population included all patients admitted to ourICU between 1993 and 2012, with a discharge diagnosis including "cardiac arrest". Patients were excluded if they did not have a cardiac arrest prior to ICU admission(i.e.,if their primary arrest was during their admission to ICU),or were not comatose on arrival to ICU. Our primary outcome measure was survival to hospital *** outcome measures were ICU and hospita length of stay(LOS), and factors associated with surviva to hospital ***: Five hundred and eighty-two comatose patients were admitted to our ICU following cardiac arrest, with 35% surviving to hospital discharge. The median ICU and hospital LOS was 3 and 5 d *** was no survival difference between in-hospital and out-of-hospital cardiac arrests. Males made up 62% of our cardiac arrest population, were more likely to have a shockable rhythm(56% vs 37%, P < 0.001), and were more likely to survive to hospital discharge(40%vs 28%, P = 0.006). On univariate analysis, therapeutic hypothermia, regardless of method used(e.g., rapid infusion of ice cold fluids, topical ice, "Arctic Sun", passive rewarming, "Bair Hugger") and location initiated(e.g.,pre-hospital, emergency department, intensive care) was associated with increased survival. There was however no difference in survival associated with target temperature,time at target temperature, location of initial cooling,method

关键词： Cardiac arrest Hypothermia Hyperthermia Arrhythmia Resuscitation

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