Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation
Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation
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DOI：
10.1001/jama.281.13.1182
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发表时间：
1999-04-07
影响因子：
120.7
通讯作者：
Hallstrom, AP
中科院分区：
文献类型：
--
作者：
Cobb, LA;Fahrenbruch, CE;Hallstrom, AP
首先到达的紧急医疗技术人员（EMT）提倡使用自动体外除颤器（AED）来改善院外室颤（VF）的结果。然而，在华盛顿州西雅图的紧急医疗系统中增加AED并没有提高生存率。动物研究表明，在最初电击前进行心肺复苏（CPR）可改善持续数分钟的室颤患者的预后。Objective To evaluate the effects of providing 90 s CPR to people with out-of-hospital VF before delivery of a shock by first arriving EMTs.设计观察性、前瞻性定义、基于人群的研究，干预前分析42个月（1990年7月1日至1993年12月31日）和36个月的干预后分析（1994年1月1日-1996年12月31日）。设置西雅图消防部门为基础，两级急诊医疗系统。参与者共639名患者接受了非急诊治疗，干预前和干预后的478例医院VF。干预修改使用AED的协议，强调在实施电击前进行约90秒的CPR。主要结果指标通过回顾性病历回顾确定出院时的存活率和神经功能状态，作为早期（
Context Use of automated external defibrillators (AEDs) by first arriving emergency medical technicians (EMTs) is advocated to improve the outcome for out-of-hospital ventricular fibrillation (VF). However, adding AEDs to the emergency medical system in Seattle, Wash, did not improve survival. Studies in animals have shown improved outcomes when cardiopulmonary resuscitation (CPR) was administered prior to an initial shock for VF of several minutes' duration.Objective To evaluate the effects of providing 90 seconds of CPR to persons with out-of-hospital VF prior to delivery of a shock by first-arriving EMTs.Design Observational, prospectively defined, population-based study with 42 months of preintervention analysis (July 1, 1990-December 31, 1993) and 36 months of postintervention analysis (January 1, 1994-December 31, 1996).Setting Seattle fire department-based, 2-tiered emergency medical system.Participants A total of 639 patients treated for out-of-hospital VF before the intervention and 478 after the intervention.Intervention Modification of the protocol for use of AEDs, emphasizing approximately 90 seconds of CPR prior to delivery of a shock.Main Outcome Measures Survival and neurologic status at hospital discharge determined by retrospective chart review as a function of early (