Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
复制标题
DOI：
10.1161/circulationaha.110.971085
复制
发表时间：
2010-11-02
期刊：
影响因子：
37.8
通讯作者：
Hazinski MF
中科院分区：
文献类型：
--
作者：
Berg MD;Schexnayder SM;Chameides L;Terry M;Donoghue A;Hickey RW;Berg RA;Sutton RM;Hazinski MF
为了获得最佳的生存率和生活质量，儿科基本生命支持（BLS）应该成为社区努力的一部分，包括预防、早期心肺复苏（CPR）、迅速进入应急响应系统和快速儿科高级生命支持（帕尔斯），然后是综合性心脏骤停后护理。这5个环节构成了美国心脏协会（AHA）儿科生存链（图1），其中前3个环节构成了儿科BLS。快速有效的旁观者CPR可与院外心脏骤停后儿童的自主循环（ROSC）成功恢复和神经系统完整生存相关。1-3旁观者复苏可能对院外呼吸骤停有最大的影响，4因为据报道，存活率为70%，神经功能结局良好。5，6旁观者复苏也可能对原发性室颤（VF）的生存率有实质性影响，因为在院外突然目睹VF的儿童中，生存率为20%至30%。7总体而言，约6%的院外心脏骤停儿童和8%的院前急救复苏儿童存活，但许多儿童因心脏骤停而遭受严重的永久性脑损伤。7，9-14及时的旁观者心肺复苏术可以改善院外存活率和神经系统结局，3，6，15-17但只有约三分之一至一半的婴儿和儿童心脏骤停患者接受旁观者心肺复苏术。3，9，12，18婴儿在院外心脏骤停中存活的可能性（4%）低于儿童（10%）或青少年（13%），这可能是因为包括在骤停数据中的许多婴儿在相当长的一段时间后被发现死亡，大多数死于婴儿猝死综合征（SIDS）。8与成人一样，初始心律为VF或无脉性室性心动过速（VT）的儿童患者的生存率高于心搏停止或无脉性电
For best survival and quality of life, pediatric basic life support (BLS) should be part of a community effort that includes prevention, early cardiopulmonary resuscitation (CPR), prompt access to the emergency response system, and rapid pediatric advanced life support (PALS), followed by integrated post–cardiac arrest care. These 5 links form the American Heart Association (AHA) pediatric Chain of Survival (Figure 1), the first 3 links of which constitute pediatric BLS.Rapid and effective bystander CPR can be associated with successful return of spontaneous circulation (ROSC) and neurologically intact survival in children following out-of-hospital cardiac arrest. 1–3 Bystander resuscitation may have the greatest impact for out-of-hospital respiratory arrest, 4 because survival rates 70% have been reported with good neurologic outcome. 5, 6 Bystander resuscitation may also have substantial impact on survival from primary ventricular fibrillation (VF), because survival rates of 20% to 30% have been documented in children with sudden out-of-hospital witnessed VF. 7 Overall about 6% 8 of children who suffer an out-ofhospital cardiac arrest and 8% of those who receive prehospital emergency response resuscitation survive, but many suffer serious permanent brain injury as a result of their arrest. 7, 9–14 Out-of-hospital survival rates and neurological outcome can be improved with prompt bystander CPR, 3, 6, 15–17 but only about one third to one half of infants and children who suffer cardiac arrest receive bystander CPR. 3, 9, 12, 18 Infants are less likely to survive out-ofhospital cardiac arrest (4%) than children (10%) or adolescents (13%), presumably because many infants included in the arrest figure are found dead after a substantial period of time, most from sudden infant death syndrome (SIDS). 8 As in adults, survival is greater in pediatric patients with an initial rhythm of VF or pulseless ventricular tachycardia (VT) than in those with asystole or pulseless electric