Public access defibrillation improved the outcome after out-of-hospital cardiac arrest in school-age children: a nationwide, population-based, Utstein registry study in Japan.
Public access defibrillation improved the outcome after out-of-hospital cardiac arrest in school-age children: a nationwide, population-based, Utstein registry study in Japan.
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DOI：
10.1093/europace/eut053
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Komada Y
中科院分区：
文献类型：
--
作者：
Mitani Y;Ohta K;Yodoya N;Otsuki S;Ohashi H;Sawada H;Nagashima M;Sumitomo N;Komada Y
本研究的目的是确定在全国范围内实施公共通路除颤(PAD)是否能改善学龄儿童院外心脏骤停(UchA)后的预后。我们进行了一项前瞻性的、全国性的、基于人群的日本Utstein登记研究，研究对象是2005-09年间有旁观者见证的假定心脏起源心跳骤停并接受急救人员院前复苏的中小学生(7-15岁)中连续发生的uchA病例。主要终点是在逮捕后1个月出现良好的神经学结果。在入选的230名符合条件的患者中，128名患者以室颤(VF)为初始心律。在这128名患者中，29名(23%)儿童首次受到旁观者的电击。在这29名患者中，神经学效果良好的患者比例为55%。在研究期间，在符合条件的患者中，最初被旁观者震惊的患者比例从2%增加到21%(趋势P=0.002)。治疗后神经系统预后良好的患者比例从12%增加到36%(P=0.006)。旁观者主动除颤的崩溃至除颤时间比急救人员除颤的时间短(3.33±3.7vs.12.9±5.8min，P<；0.001)，并且与术后良好的神经预后独立相关[P=0.03，每1min增加一次优势比(OR)0.90(95%可信区间0.82~0.99)]。一名非家庭成员的证人独立地将室颤作为初始节律[P<；0.001，OR4.03(2.08-7.80)]。在日本，PAD的实施改善了国家层面学龄儿童HEA后的结局。
The purpose of this study was to determine whether implementation of public access defibrillation (PAD) improves the outcome after out-of-hospital cardiac arrest (OHCA) in school-age children at national level. We conducted a prospective, nationwide, population-based Japanese Utstein registry study of consecutive OHCA cases in elementary and middle school children (7–15 years of age) who had a bystander-witnessed arrest of presumed cardiac origin during 2005–09 and received pre-hospital resuscitation by emergency responders. The primary endpoint was a favourable neurological outcome 1 month after an arrest. Among 230 eligible patients enrolled, 128 had ventricular fibrillation (VF) as an initial rhythm. Among these 128 patients, 29 (23%) children received a first shock by a bystander. Among these 29 patients, the proportion of the favourable neurological outcome after OHCA was 55%. During the study period, the proportion of patients initially shocked by a bystander among eligible patients increased from 2 to 21% (P = 0.002 for trend). The proportion of patients with a favourable neurological outcome after OHCA increased from 12 to 36% overall (P = 0.006). The collapse to defibrillation time was shorter in bystander-initiated defibrillation when compared with defibrillation by emergency responders (3.3 ± 3.7 vs. 12.9 ± 5.8 min, P < 0.001), and was independently associated with a favourable neurological outcome after OHCA [P = 0.03, odds ratio (OR) per 1 min increase, 0.90 (95% confidence interval 0.82–0.99)]. A non-family member's witness was independently associated with VF as the initial rhythm [P < 0.001, OR 4.03 (2.08–7.80)]. Implementation of PAD improved the outcome after OHCA in school-age children at national level in Japan.
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影响因子：
6.2
作者：
Donoghue, AJ;Nadkarni, V;Stiell, IG
通讯作者：
Stiell, IG
影响因子：
37.8
作者：
CUMMINS, RO;CHAMBERLAIN, DA;THIES, WH
通讯作者：
THIES, WH
影响因子：
2.6
作者：
Zideman, David A.;Hazinski, Mary Fran
通讯作者：
Hazinski, Mary Fran
影响因子：
37.8
作者：
Cave, Diana M.;Aufderheide, Tom P.;Schexnayder, Stephen M.
通讯作者：
Schexnayder, Stephen M.
DOI：
10.1056/nejmoa1010663
发表时间：
2011-01-27
期刊：
The New England journal of medicine
影响因子：
--
作者：
Weisfeldt ML;Everson-Stewart S;Sitlani C;Rea T;Aufderheide TP;Atkins DL;Bigham B;Brooks SC;Foerster C;Gray R;Ornato JP;Powell J;Kudenchuk PJ;Morrison LJ;Resuscitation Outcomes Consortium Investigators
通讯作者：
Resuscitation Outcomes Consortium Investigators