中国成人心搏骤停后综合征器械支持治疗临床实践指南

Clinical practice guidelines for device supportive care in adults with post cardiac arrest syndrome in China

心搏骤停(CA)患者自主循环恢复(ROSC)后发生再灌注损伤,导致机体出现多器官功能障碍,称为心搏骤停后综合征(PCAS)。PCAS与CA患者预后密切相关,是影响复苏患者存活率的独立危险因素,针对PCAS患者的器械支持治疗是改善其预后的重要手段。为指导和规范我国临床医师、护理人员及相关教学和研究人员对PCAS器械支持治疗的认识和使用,在世界卫生组织(WHO)指南制定手册的指导下,以推荐意见的分级、制订及评价(GRADE)系统为工具制订了首部PCAS器械支持治疗临床实践指南,指南围绕PCAS患者神经系统保护、循环系统治疗、呼吸系统支持及肾脏替代治疗等4个方面7种支持器械形成16条推荐意见,为现阶段PCAS临床诊疗提供参考和依据。

Post cardiac arrest syndrome(PCAS)refers to the multiple organ dysfunction or failure after return of spontaneous circulation(ROSC)in cardiac arrest(CA)patients.PCAS is closely related to the prognosis of CA patients,and is an independent risk factor of survival.Device supportive care is critical for improving prognosis of PCAS.In order to guide and standardize device supportive care in PCAS among clinicians,nurses and research personnel in China,the working group drafted the first clinical practice guidelines for device supportive care in adults with PCAS according to World Health Organization(WHO)guideline development manual,with the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.The guidelines developed sixteen recommendations on seven types of devices in four aspects including neuroprotection,circulatory treatment,respiratory support and renal replacement therapy,providing references for clinical management of PCAS.