早期机械通气对成人院内心脏骤停病死率的影响:一项回顾性队列研究  

Impact of early mechanical ventilation on mortality rates in adult in-hospital cardiac arrest: a retrospective cohort study

作　　者：刘晴雯 韩勇[2] 陈丽丹 邓哲[2] Liu Qingwen;Han Yong;Chen Lidan;Deng Zhe(Shantou University Medical College,Shantou 515041,China;Department of Emergency,Shenzhen Second People's Hospital/First Affiliated Hospital of Shenzhen University,Shenzhen 518035,China;Headquarters of Nanshan Medical Group,Shenzhen 518000,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]深圳市第二人民医院(深圳大学第一附属医院)急诊科,广东深圳518035 [3]深圳市南山区医疗集团总部,广东深圳518000

出　　处：《中华卫生应急电子杂志》2024年第4期203-206,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：深圳市科技计划(JCYJ20180228163014668);广东省高水平医院建设项目深圳市第二人民医院临床研究基金(20223357005,2023xgyj3357002)。

摘　　要：目的回顾性分析早期机械通气对成人院内心脏骤停(IHCA)病死率的影响,为IHCA患者是否实施早期机械通气提供理论依据。方法纳入2006 年至2014 年间在国立台湾大学医院接受至少2 min 胸外按压的1 540 例成人IHCA 患者。以IHCA 患者死亡为结局指标,采用单变量分析及多变量的Logistic 回归模型分析早期机械通气与病死率之间的关系。结果1540 例成人IHCA 患者中,329 例(21.36%)接受了早期机械通气,1211 例(78.64%)未接受早期机械通气。两组患者病死率分别为89.67%(95% CI:86.38~92.96)和84.39%(95% CI:82.35~86.44)。多变量Logistic 回归模型显示,接受早期机械通气的IHCA 患者的死亡风险较未接受机械通气的患者增加了58%(OR:1.580,95% CI:1.03~2.43,P=0.04)。结论在IHCA 患者中,早期机械通气是死亡的独立危险因素,早期机械通气可能增加IHCA患者的病死率。Objective To analyze the impact of early mechanical ventilation on the mortality of adult in-hospital cardiac arrest (IHCA) retrospectively and to provide a theoretical basis for whether early mechanical ventilation should be implemented in IHCA patients.Methods This study included 1540 adult IHCA patients who received at least two minutes of external chest compressions at Taiwan University Hospital from 2006 to 2014. Mortality of IHCA patients was the outcome indicator used, and the relationship between early mechanical ventilation and mortality was analyzed using univariate analysis and multivariate logistic regression models.Results Among the 1540 adult IHCA patients, 329 (21.36%)received early mechanical ventilation, while 1211 (78.64%) did not. The respective mortality rates were 89.67% (95% CI: 86.38~92.96) and 84.39% (95% CI: 82.35~86.44). The multivariate logistic regression model showed that the risk of death for IHCA patients receiving early mechanical ventilation was increased by 58% (OR: 1.580, 95% CI: 1.03~2.43, P=0.04) compared to those who did not receive mechanical ventilation.ConclusionEarly mechanical ventilation is an independent risk factor of mortality in IHCA patients,and it may increase the death rate in these patients.

关 键 词：院内心脏骤停 早期机械通气 病死率 心肺复苏 

分 类 号：R541.78[医药卫生—心血管疾病]