The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial
The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial
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DOI：
10.1016/j.resuscitation.2013.10.014
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发表时间：
2014-03-01
期刊：
影响因子：
6.5
通讯作者：
Christenson, Jim
中科院分区：
文献类型：
--
作者：
Cheskes, Sheldon;Schmicker, Robert H.;Christenson, Jim
背景：先前的研究已经证明了休克期暂停与院外休克性心脏骤停（OHCA）出院存活率之间的显著关系。目的：在ROC PRIMED随机对照试验中，确定休克期暂停对OHCA患者生存的影响。方法：我们在ROC PRIMED试验中纳入了2007年6月至2009年11月期间遭受OHCA的患者，这些患者表现为可休克性心律，并具有至少一次休克的CPR过程数据。我们使用多变量逻辑回归来确定围休克暂停时间和存活至出院之间的关系。结果：在研究的2006例患者中，中位（IQR）休克暂停时间为：休克前暂停15秒（8,22）；休克后暂停6 s (4,9)；围休克暂停22.0 s（14,31）。在调整了Utstein生存预测因子和CPR质量指标后，休克前暂停= 40 s的患者存活至出院的几率明显更高。休克后暂停与存活至出院无显著相关性。神经系统完整生存率（修正Rankin评分）
Background: Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA).Objective: To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial.Methods: We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge.Results: Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause = 40 s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score