关键词： arrhythmia   cardiopulmonary resuscitation   pediatrics   HOSPITAL CARDIAC-ARREST   RAPID RESPONSE SYSTEM   DENGUE SHOCK SYNDROME   SHORT-TERM SURVIVAL   THERAPEUTIC HYPOTHERMIA   VENTRICULAR-FIBRILLATION   FLUID RESUSCITATION   NEUROLOGIC OUTCOMES   INCREASED MORTALITY   CARBON-DIOXIDE  

摘要： The article investigates the advanced life support for pediatric in-hospital cardiac arrest (IHCA). Information about the rates of return of spontaneous circulation (ROSC) and survival to hospital discharge from intensive care unit (ICU), is given. Also examined is the systematic review of the potential conflicts of interest based on the 2015 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care from U.S. nonprofit organization American Heart Association (AHA).

关键词： advance directive   DNAR   life support   organ donation   HOSPITAL CARDIAC-ARREST   TIDAL CARBON-DIOXIDE   EXTRACORPOREAL MEMBRANE-OXYGENATION   HYPOXIC-ISCHEMIC ENCEPHALOPATHY   ORGAN DONATION   THERAPEUTIC HYPOTHERMIA   OUTCOME PREDICTION   INTENSIVE-CARE   CIRCULATORY DETERMINATION   PROPENSITY ANALYSIS  

摘要： Managing the multiple decisions associated with resuscitation is challenging from many perspectives, and no more so than when healthcare providers are dealing with the ethics surrounding decisions to provide or withhold emergency cardiovascular care. This is especially true with the increasing availability of technologies that hold the promise of improved outcomes after cardiac arrest, such as ECPR and TTM. © 2015 American Heart Association, Inc., and The American National Red Cross.

关键词： cardiac arrest   cardiopulmonary resuscitation   emergency   resuscitation   HOSPITAL CARDIAC-ARREST   INTERNATIONAL CONSENSUS   SURVIVAL   SCIENCE   IMPLEMENTATION   QUALITY  

摘要： The process used to generate the 2015 Guidelines Update has been remarkably different from prior releases of the Guidelines. The combination of (1) ILCOR process of selecting a reduced number of priority topics for review, (2) using the GRADE process of evaluation, and (3) merging the Grade recommendations with the current prescribed AHA classification system to assign LOE and COR is unique to the 2015 Guidelines Update. Thus, the 2015 Guidelines Update is leaner compared with the 2010 Guidelines publication because fewer topics were addressed by the 2015 ILCOR evidence review process than were reviewed in 2010. There were a total of 685 recommendations in the 2010 Guidelines, and there are a total of 315 recommendations in the 2015 Guidelines Update. The number of systematic reviews is lower in 2015; however, the quality of the reviews may be higher and more consistent based on the involvement of information specialists, the rigorous oversight of the SEERS process, and the use of the GRADE process of review. © 2015 American Heart Association, Inc., and The American National Red Cross.

关键词： 高级生命支持   美国心脏协会   心肺复苏   新指南   儿童   危重症患儿   解读   心血管急救  

摘要： 2015年美国心脏协会（American Heart Association，AHA）颁布了心肺复苏（cardiopulmonary resuscitation，CPR）及心血管急救新指南。2010版指南是对危重症患儿特别是存在呼吸和（或）心脏骤停高风险患儿的综合管理与处理，其中包括了与儿童高级生命支持（pediatric advanced lifesupport，

关键词： 院外心脏骤停   心肺复苏   亚低温治疗  

摘要： 目的探讨院外亚低温治疗与心肺复苏同时进行抢救心脏骤停患者的临床效果。方法选取回顾分析北京急救中心2011年1月至2014年1月院外抢救心脏骤停的患者63例,随机分为两组:对照组30例,采用经心肺复苏(CPR)自主循环恢复后送至院内再行亚低温治疗;亚低温治疗(mild hypothermia therapy,MHT)组33例,心肺复苏与亚低温治疗同时进行。对比两组患者CPR前的肛门温度,到达医院时肛门温度以及达到目标温度所用时间,比较两组患者在复苏后第1、3、7天格拉斯哥昏迷量表(GCS)评分,以及存活例数。结果 MHT组到达医院时,有5例肛温达到目标温度,平均肛温(34.7±0.8)℃,低于对照组的(36.4±1.6)℃,差异有统计学意义(P<0.05)。MHT组达到目标温度平均用时(3.0±1.8)h,低于对照组的(5.7±2.0)h,差异有统计学意义(P<0.05)。两组患者复苏后当天GCS评分差异无统计学意义[(6.9±1.5)vs.(6.8±1.3)];复苏后第7天,MHT组比对照组明显升高[(12.1±1.6)vs.(9.7±1.9)],差异有统计学意义(P<0.05)。MHT组最终存活9例,对照组存活6例,两组比较差异无统计学意义(P>0.05)。结论在院外心肺复苏的同时开始亚低温治疗,可以达到更好的脑保护效果,增加了患者的生存率,值得在院外抢救心脏骤停中推广。

关键词： ADULT CRITICAL-CARE   CARDIOPULMONARY-RESUSCITATION   HEALTH-CARE   PRACTICE GUIDELINES   MEMBER PRESENCE   NURSES WORKING   CENTERED CARE   EXPERIENCE   PATIENT   ATTITUDES  

摘要： Background Although patients' families want to be invited to the bedside of hospitalized loved ones during crisis events, little is known about patients' perceptions of family presence. Objective To explore adult inpatients' perceptions of family presence during resuscitation, near-resuscitation, and unplanned invasive cardiac procedures shortly after the life-threatening event. Methods In this qualitative study, data were collected by interviews at least 13 hours after a crisis event and before hospital discharge. Data were audio recorded, transcribed, and analyzed for themes. Results From the bedside interviews (N = 48), the over-arching theme of "being there" was explained more specifically as "being there is beneficial," " being there is hard," " families in the way," and "desire for control." Most participants preferred family presence, although preferences varied with types of crisis events, patients' predictions of family members' responses, and the nature of family relationships. New perspectives emerged about patients' decision making related to family presence. Conclusions This study extends existing knowledge about factors that influence the decision-making processes of hospitalized patients regarding family presence during a crisis event. Health care professionals can provide support as patients ponder difficult decisions about who to have present and can reduce patients' fears that families might interfere with the life-saving efforts.

关键词： 亚低温   心脏骤停   复苏   优化治疗  

摘要： 目的:探讨亚低温治疗对于急诊心脏骤停患者复苏后优化治疗的疗效。方法:选取我院2013-01-2015-01收治的心脏骤停患者50例,将其随机分为观察组和对照组,每组25例,观察组患者采用亚低温治疗,对照组采用传统头部降温法,比较2组患者从自主循环恢复(ROSC)后到开始实施降温的时间(ROSC-IH),达到目标温度的例数,开始降温到达到目标温度的时间(IH-TT),并比较2组并发症及3个月后大脑功能评分分级(CPC)情况。结果:观察组患者达到目标温度的例数多于对照组,且其IH-TT时间短于对照组(P<0.05);2组患者并发症比较差异无统计学意义(P>0.05),治疗后3个月观察组达到良好脑功能的患者多于对照组,脑死亡病例数低于对照组,2组比较差异有统计学意义(P<0.05)。结论:亚低温治疗应用于急诊心脏骤停患者复苏后优化治疗效果显著,是一种安全、有效、简单易行的降温技术,值得进一步推广应用。

关键词： 心脏骤停   心肺复苏   急救  

摘要： 目的 分析心脏骤停患者心肺复苏的影响因素，积累临床经验，提高患者生存率。 方法 回顾性研究207例院前及院内发生心脏骤停实施心肺复苏患者，分别从年龄、性别、病因、复苏地点、复苏开始时间、人工通气、电除颤、药物对心肺复苏的影响等进行分析。 结果 复苏成功患者与不成功患者在年龄、病因、复苏地点、复苏开始时间、人工通气方法方面比较差异有统计学意义（ P<0.05）。 结论 第一时间实施心肺复苏是抢救心脏骤停的关键。

关键词： 美国心脏协会   心肺复苏   心血管急救   指南   持续质量改进   高级心血管生命支持   基础生命支持   基本生命支持  

摘要： 10月15日,美国心脏协会（AHA）公布了《2015心肺复苏和心血管急救指南更新》。本次更新共包括执行摘要、证据评价与利益冲突管理、伦理学问题、急救系统和持续质量改进、成人基础生命支持和心肺复苏质量（非专业施救者心肺复苏）、成人基础生命支持和心肺复苏质量（医护人员基本生命支持）、成人高级心血管生命支持、儿童高级生命支持等15部分文件。

关键词： 心肺复苏   基础生命支持   美国心脏协会   儿童   解读   指南   2009年   存活出院率  

摘要： 过去10年间，儿童院内心脏骤停（in—hospitalcardiacarrest，IHCA）的预后有了明显改善。从2001年至2009年，儿童IHCA存活出院率从24％提高到了39％。并且延长心肺复苏（cardiopulmonaryresuscitation，CPR）时间也使部分患儿获益，