Improved criteria for admission to cardiac care units.
Improved criteria for admission to cardiac care units.
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改善了心脏护理病房的入院标准。
DOI：
10.1001/jama.1981.03320180029024
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
S. Scheidt
中科院分区：
文献类型：
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作者：
R. Fuchs;S. Scheidt
从 414 名已知或疑似心肌梗塞 (MI) 的连续入院患者中识别出需要专门心脏监护病房干预 (CCUI) 的患者。心脏监护病房的干预措施包括给予盐酸利多卡因、硫酸阿托品、硝普钠或血管加压药； Swan-Ganz 或动脉导管插入术；插入临时起搏器；和电击。几乎所有干预措施都发生在具有以下三种发现中的一项或多项的高危人群中：(1) 持续胸痛，(2) 肺部啰音，或 (3) 12 导联心电图显示一种或多种室性早搏 (VPC)。在 306 名高危患者中，41% 接受了至少一次 CCUI，4% 在 CCU 中死亡。相比之下，在不符合这三个标准的 108 名低风险患者中，只有 6% 接受了任何 CCUI，并且没有人在 CCU 中死亡。这项研究表明，首次评估时没有持续性 VPC 疼痛、充血性心力衰竭的患者出现早期并发症的风险非常低，可能不需要重症监护。
Patients requiring specialized cardiac care unit interventions (CCUIs) were identified from 414 consecutive admissions with known or suspected myocardial infarction (Ml). Cardiac care unit interventions included administration of lidocaine hydrochloride, atropine sulfate, sodium nitroprusside, or vasopressors; Swan-Ganz or arterial catheterization; insertion of temporary pacemaker; and electroshock. Almost all interventions occurred in a high-risk group that had one or more of three findings: (1) ongoing chest pain, (2) pulmonary rales, or (3) one or more ventricular premature contractions (VPCs) on 12-lead ECG. Of 306 high-risk patients, 41% received at least one CCUI, and 4% died in the CCU. In contrast, of the 108 low-risk patients with none of the three criteria, only 6% received any CCUI, and none died in the CCU. This study suggests that patients who do not have ongoing pain, congestive heart failure, of VPCs when first evaluated have a very low risk of early complications and may not require intensive care.