关键词： cardiopulmonary resuscitation (CPR)   cardiac rehabilitation (CR)   anxiety   depression   perception of control   out-of-hospital   training   cardiac arrest   CORONARY-HEART-DISEASE   HOSPITAL ANXIETY   FAMILY-MEMBERS   EUROPEAN-SOCIETY   ARREST PATIENTS   MONICA PROJECT   CARE PATIENTS   EVENT RATES   TASK-FORCE   DEPRESSION  

摘要： As a component of cardiac rehabilitation (CR), cardiopulmonary resuscitation (CPR) training is widely recommended. These recommendations advocate the importance of offering CPR training to cardiac patients' families. Prior research examining the effect of CPR training on the cardiac patients spouse or family member, suggests that receiving CPR training within a supportive environment such as cardiac rehabilitation causes no adverse psychological effects in the family members. Patients are often excluded from CPR training due to fears of the possible physiological consequences. Conversely, there may be negative psychological consequences for patients who are excluded from CPR training. Although cardiac patients are at high risk of cardiac arrest themselves this should not preclude them from having the ability to help another. The aim of this study was to assess the impact on anxiety, depression and perception of control (POC) of CPR training for the cardiac patients as an integral part of an 8-week phase III Cardiac Rehabilitation Programme. Fifty-eight patients and 54 family members or partners attending an 8-week CR programme were offered optional CPR training during the final week of the programme. Forty-nine patient subjects were evaluated at four time points, using the hospital anxiety and depression scale and the control attitudes scale. Seventy-five percent (n = 37) of patients participated in the CPR training. Teaching CPR to cardiac patients did not affect anxiety levels adversely. There was an overall significant decrease in anxiety scores for both patient groups over time (p = 0.0071). Both patient groups showed an average moderate level of POC at baseline but the POC level in those who did the CPR training continued to increase slightly throughout the study period. If the patient agreed to undertake CPR training approximately 61% of their relatives or partners also undertook the training, but when the patient did not avail of the CPR training only 20% of

关键词： CARDIOPULMONARY-RESUSCITATION   CARDIOCEREBRAL RESUSCITATION   ARREST  

摘要： Cardiac arrest is a leading cause of death in the United States.1 In spite of periodic updates of the Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of the American Heart Association (AHA) (hereafter referred to as the AHA guidelines), survival rates are dismal in the absence of early defibrillation and have remained essentially unchanged for decades.1,2 In large cities in the United States, overall survival of out-of-hospital arrest of presumed cardiac cause is about 1 percent — approximately the rate that has been suggested to define medical futility.2,3 The cost of providing emergency medical services (EMS) to . . .

关键词： 心脏停搏   心肺复苏术   护理  

摘要： Q-T间期延长综合征发作尖端扭转室速(TDP)、室颤是导致患者死亡的主要原因。抢救用物的充分准备,密切观察病情变化,监测心率、心律和血压的变化,尤其是及时发现心电图的异常,并进行积极的电复律是抢救成功的关键;早期头部放置冰帽、大动脉冷敷及保持亚低温状态以保护脑细胞,是提高患者生活质量的重要保证。

关键词： 胸外心脏按压   心肺复苏术   抢救成功率   标准   中成   高频   心跳停止病人   抢救术   复苏法  

摘要： 心肺复苏术(CPR)是指对抢救呼吸、心跳停止病人的抢救术.胸外心脏按压是指在心肺复苏术中的第一个抢救步骤.如何提高抢救成功率,世界各国都在不断探讨中.

关键词： in-hospital cardiac arrest   cardiopulmonary resuscitation   medical emergency team   Utstein template   MEDICAL EMERGENCY TEAM   MORTALITY   ASSOCIATION   AREAS   TRIAL   WARDS   SIGNS  

摘要： Background: Patients suffering in-hospital cardiac arrest (IHCA) often have abnormal clinical observations documented prior to the arrest. This study assesses whether these patients have a less favourable outcome following IHCA. Methods: A multiple logistic regression analysis of retrospectively collected hospital chart data and prospectively collected Utstein style resuscitation data. Patients were defined as having abnormal clinical observations if they had one of the following documented 8 h before the arrest: systolic arterial blood pressure below 90 or over 200, pulse rate below 40 or over 140 beats per min or oxygen saturation below 90% with or without supplemental oxygen. Pre-arrest variables included were: age, sex and functional status, co-morbidities, reason for hospital admission, days in the hospital before the arrest, witnessed or un-witnessed arrest, arrest occurring outside regular working hours, monitored or non-monitored ward, whether basic life support was performed before the arrival of the resuscitation team, delay to arrival of resuscitation team and initial rhythm. Results: Survival to hospital discharge of patients with clinically abnormal observations was 9% and among those without 18% (p=0.037). Independent pre-arrest predictors of survival were: un-witnessed arrest (odds ratio [OR] 0.1, confidence interval (0) 0.01-0.8), initial rhythm other than ventricular fibrillation or ventricular tachycardia (OR 0.13, Cl 0.05-0.3), delay to arrival of the resuscitation team exceeding 2 min (median) (OR 0.4, Cl 0.15-0.9) and the presence of documented clinical abnormal observations prior to the arrest (OR 0.3, Cl 0.09-0.95). Conclusions: Patients with documented clinically abnormal observations before IHCA have a worse outcome than those without, despite prompt resuscitation. Efforts should be made to identify these patients in time, thereby possibly avoiding the arrest. This can also be used when assessing the prognosis in IHCA. (c) 2006 Elsevier Irel

关键词： 急性左心衰竭   肺水肿   心脏骤停   心肺复苏  

摘要： 急性左心衰肺水肿是一种危及生命的心血管病急症，而其导致心脏骤停后再能够成功进行CPR的病例则更为少见。2006—04—27我科对1例急性左心衰肺水肿导致心脏骤停的患者成功地进行了心肺复苏（CPR），现报道如下。

关键词： sudden death   cardiopulmonary resuscitation   coronary angiography   cardiopulmonary bypass   controlted myocardial reperfusion   HOSPITAL CARDIOPULMONARY-RESUSCITATION   ACUTE REGIONAL ISCHEMIA   BLOOD CARDIOPLEGIA   CEREBRAL RESUSCITATION   MYOCARDIAL-INFARCTION   ENRICHED BLOOD   ARREST   SURVIVAL   EMERGENCY   BYPASS  

摘要： Background: The fundamental goal of cardiopulmonary resuscitation (CPR) is recovery of the heart and the brain. This is best achieved by (1) immediate CPR for coronary and cerebral perfusion, (2) correction of the cause of cardiac arrest, and (3) controlled cardioptegic cardiac reperfusion. Failure of such an integrated therapy may cause permanent brain damage despite cardiac resuscitation. Methods: This strategy was applied at four centers to 34 sudden cardiac death patients (a) after acute myocardial infarction (n=20), (b) "intraoperatively" following successful discontinuation of cardiopulmonary bypass (n=4), and (c) e 'postoperatively" in the surgical ICU (n = 10). In each witnessed arrest the patient failed to respond to conventional CPR with ACLS interventions, including defibrillation. The cardiac arrest interval was 72 +/- 43 min (20-150 min). Compression and drugs maintained a BP > 60 mmHg to avoid cerebral hypoperfusion. Operating room (OR) transfer was delayed until the blood pressure was monitored. In four patients femoral bypass maintained perfusion white an angiographic diagnosis was made. Results: Management principles included no repeat defibrillation attempts after 10 min of unsuccessful CPR, catheter-monitored peak BP > 60 mmHg during diagnosis and transit to the operating room, left ventricular venting during cardiopulmonary bypass and 20 min global and graft substrate enriched blood cardioplegic reperfusion. Survival was 79.4% with two neurological complications (5.8%). Conclusions: Recovery without adverse neurological outcomes is possible in a large number of cardiac arrest victims following prolonged manual CPR. Therapy is directed toward maintaining a monitored peak BP above 60 mmHg, determining the nature of the cardiac cause, and correcting it with controlled reperfusion to preserve function. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

关键词： 心肺复苏术   美国心脏学会   心血管急症   大剂量肾上腺素   指南   监护   胸部按压   临床试验   常规应用   病死率  

摘要： 在儿童复苏术方面,强调实施有效胸部按压及通气。Pemndi等(2004)进行的一项前瞻性随机设对照的临床试验表明,常规应用大剂量肾上腺素对儿童无益,实际是反而可能增加罹患率及病死率。[第一段]

关键词： 院前急救医师   复苏成功率   心脏骤停   临床分析   心肺复苏   急诊医学   成功抢救  

摘要： 心脏骤停(CA)是常见的临床最紧急的危险情况之一,心肺复苏(CPR)是急诊医学的重要课题.如何进一步提高院前对心脏骤停患者的心肺复苏成功率是院前急救医师不断思考的问题,现就我中心成功抢救的20例心脏骤停病例进行分析.

关键词： 生脉注射液   心肺复苏   综述  

摘要： 生脉饮源自<内外伤辨惑论·中暑伤胃气论>,由人参、麦冬、五味子(1:3.12:1.56)3味中药组成,是益气复脉的基础方,在中医学中是抢救垂死病人的重要方剂.研究证明,生脉可以加强窦房结电信号,稳定信号传递,增加心肌灌注量,减轻缺血再灌注损伤作用明显,对于提高心脏复苏成功率、生存率及生活质量有重要意义.说明生脉在心脏复苏过程中有很好的应用价值.现将生脉方研究进展综述如下.