Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness i...Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness is the key to successful CPR; as such,Prof.He proposed the 'platinum 10 min' system to study early CPR issues.This paper systematically evaluates the success rates of heartbeat restoration within the 'platinum 10min' among patients suffering from sudden cardiac arrest.Methods:The clinical data of outpatients suffering from a cardiac arrest were retrieved from the China Knowledge Network(January 1975-January 2015),the Chongqing VIP database(January 1989-January 2015),and the Wanfang database(January 1990-January 2015).The success of the cardiopulmonary resuscitation(CPR) performed at different times after the patients had cardiac arrests was analyzed.Two researchers screened the literature and extracted the data independently.A meta-analysis was conducted using Stata 12.0.A total of 57 papers met the inclusion criteria,including 29,269 patients.Of these patients,1,776 had their heartbeats successfully restored.The results showed high heterogeneity(χ~2=3428.85,P<0.01,I2=98.4%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.171(0.144-0.199).Results:1) The success rate of heartbeat restoration did not differ among the four emergency treatment methods that patients received:the methods described in the 2000 Guidelines for CPR and Emergency Cardiovascular Care,that described in the 2005 version,2010 version,and another CPR method.2) The patients were divided into five groups based on the time when CPR was performed:the ?1min group,the 1-5min group,the 5-10 min group,the 10-15 min group and the >15min group.The CPR success rates of these five groups were 0.247(0.15-0.344),0.353(0.250-0.456),0.136(0.109-0.163),0.058(0.041-0.075),and 0.011(0.004-0.019),respectively.The CPR success rates did not differ between the patients in the ?1min group and the 1-5min group.This success rate was higher for the patients in the 1-5min group than those in the 10-15 min group,those in the 10-15 min group,and those in the >15min group.The CPR success rate was higher for the patients in the 5-10 min group than those in the 10-15 min group and those in the >15min group.The CPR success rate was higher for the patients in the 10-15 min group than those in the >15min group.In addition,the patients were divided into two groups based on whether CPR was performed within the first 10 min after the cardiac arrest occurred:the ?10min group and the >10min group.The CPR success rate was higher for the patients in the ?10min group [0.189(0.161-0.218)] than those in the >10min group [0.044(0.032-0.056)].3) Differences were not found between the CPR success rates among the patients in the telephone guidance group [0.167(0.016-0.351)] and those in the ?1min,1-5min,5-10 min,10-15 min,and >15min groups.4) The CPR success rates did not differ among in the patients in the witness + public group [0.329(0.221-0.436)],those in the ?1min group,and those in the 1-5min group.However,this success rate was higher in the patients in the witness + public group than those in the 5-10 min,10-15 min,and >15min groups.Conclusion:The success rate of heartbeat restoration did not differ among patients receiving CPR based on different guidelines.The success rate of CPR lies in its timeliness.The participation of the general population is the cornerstone of improving CPR.Providing complete emergency treatment equipment and perfecting comprehensive measures can improve the success rate of CPR among patients within the platinum 10 min.CPR research in China must be improved.展开更多
目的自主研发弹射式一次性骨髓腔输液器并探讨其在临床心肺复苏中的应用价值。方法在临床抢救过程中对心肺复苏患者,选择胫骨上端、桡骨远端、肱骨头、胸骨4个部位的8个骨髓穿刺点,使用弹射式一次性骨髓输液器,与传统方法共同复苏抢救患...目的自主研发弹射式一次性骨髓腔输液器并探讨其在临床心肺复苏中的应用价值。方法在临床抢救过程中对心肺复苏患者,选择胫骨上端、桡骨远端、肱骨头、胸骨4个部位的8个骨髓穿刺点,使用弹射式一次性骨髓输液器,与传统方法共同复苏抢救患者,观察、统计相关指标。结果应用于重症医学科35例、骨科3例,其中男性24例,女性12例;年龄17~78岁。抢救无效9例,心跳恢复29例,其中循环恢复>4 h 21例、<4 h 8例。胫骨上端、桡骨远端、肱骨头、胸骨在自然重力条件下的输液速度分别为16.5 m L/min、7.2 m L/min、15.0 m L/min、23.8 m L/min,加压输液可以达到50 m L/min或更高。操作成功时间15~120 s(操作速度:如果准备得当,操作熟练,操作开始到可以输液仅在15~20 s内完成,不熟练也可在60~120 s内完成)。保留时间4~6 h、拨针后局部未发现骨折。输入的液体包括血浆、血浆代用品、等渗盐水或林格氏液。弹射式一次性骨髓输器使用成功率为100%(38/38)。结论骨髓输液的时效性不仅在院前,还在院内,甚至是重症医学科,发挥其快速、可靠、便捷的输液优势,在"白金十分钟"内取得最佳的复苏效果。展开更多
目的系统评价院前心肺复苏患者自主循环恢复率15年的的变化趋势。方法检索数据库中国知网(1979年1月至2019年3月)、重庆维普数据库(1989年1月至2019年3月)、数据库万方(1990年1月至2019年3月)和Web of Science(1900年1月至2020年5月)相...目的系统评价院前心肺复苏患者自主循环恢复率15年的的变化趋势。方法检索数据库中国知网(1979年1月至2019年3月)、重庆维普数据库(1989年1月至2019年3月)、数据库万方(1990年1月至2019年3月)和Web of Science(1900年1月至2020年5月)相关文献,进行研究。收集汇总院前心搏骤停病患的相关临床资料,进行不同时间的心肺复苏数据分析。本研究由两名工作者独立的进行文献检索、筛选、收集资料,采用R软件的meta package进行分析(版本号3.61)。结果经纳入与排除的标准,共有文献资料共114篇,患者总计26334例,其中心搏恢复人数为2229例。异质性检验χ^(2)=5288.48,P<0.01,I=96.3%,存在高度异质性。如果数据存在高度的异质性,运用随机效应模型对数据进行分析。1.合并效应量为0.241[0.192;0.297],即研究期间,自主循环恢复率为24.1%;2.三个时间段2004至2008年、2009至2013年、2014至2018年自救循环恢复率分别为0.200[0.135;0.286]、0.230[0.147;0.342]、0.281[0.203;0.376],其自救循环恢复率有上升趋势,但三组之间没有统计学差异。结论1.对15年每隔5年时段的院前心肺复苏自救循环恢复率有逐段升高趋势的现象,但无统计学差异。2.心肺复苏在目击下就开始抢救,应在10 min之内,尽早尽快,越快越好。3.用时效规律引领今后的努力方向才是正确的:把急救技术储存在民间,并在公共场所装配AED设备,才能实现最大的抢救潜能。展开更多
文摘Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness is the key to successful CPR; as such,Prof.He proposed the 'platinum 10 min' system to study early CPR issues.This paper systematically evaluates the success rates of heartbeat restoration within the 'platinum 10min' among patients suffering from sudden cardiac arrest.Methods:The clinical data of outpatients suffering from a cardiac arrest were retrieved from the China Knowledge Network(January 1975-January 2015),the Chongqing VIP database(January 1989-January 2015),and the Wanfang database(January 1990-January 2015).The success of the cardiopulmonary resuscitation(CPR) performed at different times after the patients had cardiac arrests was analyzed.Two researchers screened the literature and extracted the data independently.A meta-analysis was conducted using Stata 12.0.A total of 57 papers met the inclusion criteria,including 29,269 patients.Of these patients,1,776 had their heartbeats successfully restored.The results showed high heterogeneity(χ~2=3428.85,P<0.01,I2=98.4%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.171(0.144-0.199).Results:1) The success rate of heartbeat restoration did not differ among the four emergency treatment methods that patients received:the methods described in the 2000 Guidelines for CPR and Emergency Cardiovascular Care,that described in the 2005 version,2010 version,and another CPR method.2) The patients were divided into five groups based on the time when CPR was performed:the ?1min group,the 1-5min group,the 5-10 min group,the 10-15 min group and the >15min group.The CPR success rates of these five groups were 0.247(0.15-0.344),0.353(0.250-0.456),0.136(0.109-0.163),0.058(0.041-0.075),and 0.011(0.004-0.019),respectively.The CPR success rates did not differ between the patients in the ?1min group and the 1-5min group.This success rate was higher for the patients in the 1-5min group than those in the 10-15 min group,those in the 10-15 min group,and those in the >15min group.The CPR success rate was higher for the patients in the 5-10 min group than those in the 10-15 min group and those in the >15min group.The CPR success rate was higher for the patients in the 10-15 min group than those in the >15min group.In addition,the patients were divided into two groups based on whether CPR was performed within the first 10 min after the cardiac arrest occurred:the ?10min group and the >10min group.The CPR success rate was higher for the patients in the ?10min group [0.189(0.161-0.218)] than those in the >10min group [0.044(0.032-0.056)].3) Differences were not found between the CPR success rates among the patients in the telephone guidance group [0.167(0.016-0.351)] and those in the ?1min,1-5min,5-10 min,10-15 min,and >15min groups.4) The CPR success rates did not differ among in the patients in the witness + public group [0.329(0.221-0.436)],those in the ?1min group,and those in the 1-5min group.However,this success rate was higher in the patients in the witness + public group than those in the 5-10 min,10-15 min,and >15min groups.Conclusion:The success rate of heartbeat restoration did not differ among patients receiving CPR based on different guidelines.The success rate of CPR lies in its timeliness.The participation of the general population is the cornerstone of improving CPR.Providing complete emergency treatment equipment and perfecting comprehensive measures can improve the success rate of CPR among patients within the platinum 10 min.CPR research in China must be improved.
文摘目的自主研发弹射式一次性骨髓腔输液器并探讨其在临床心肺复苏中的应用价值。方法在临床抢救过程中对心肺复苏患者,选择胫骨上端、桡骨远端、肱骨头、胸骨4个部位的8个骨髓穿刺点,使用弹射式一次性骨髓输液器,与传统方法共同复苏抢救患者,观察、统计相关指标。结果应用于重症医学科35例、骨科3例,其中男性24例,女性12例;年龄17~78岁。抢救无效9例,心跳恢复29例,其中循环恢复>4 h 21例、<4 h 8例。胫骨上端、桡骨远端、肱骨头、胸骨在自然重力条件下的输液速度分别为16.5 m L/min、7.2 m L/min、15.0 m L/min、23.8 m L/min,加压输液可以达到50 m L/min或更高。操作成功时间15~120 s(操作速度:如果准备得当,操作熟练,操作开始到可以输液仅在15~20 s内完成,不熟练也可在60~120 s内完成)。保留时间4~6 h、拨针后局部未发现骨折。输入的液体包括血浆、血浆代用品、等渗盐水或林格氏液。弹射式一次性骨髓输器使用成功率为100%(38/38)。结论骨髓输液的时效性不仅在院前,还在院内,甚至是重症医学科,发挥其快速、可靠、便捷的输液优势,在"白金十分钟"内取得最佳的复苏效果。
文摘目的系统评价院前心肺复苏患者自主循环恢复率15年的的变化趋势。方法检索数据库中国知网(1979年1月至2019年3月)、重庆维普数据库(1989年1月至2019年3月)、数据库万方(1990年1月至2019年3月)和Web of Science(1900年1月至2020年5月)相关文献,进行研究。收集汇总院前心搏骤停病患的相关临床资料,进行不同时间的心肺复苏数据分析。本研究由两名工作者独立的进行文献检索、筛选、收集资料,采用R软件的meta package进行分析(版本号3.61)。结果经纳入与排除的标准,共有文献资料共114篇,患者总计26334例,其中心搏恢复人数为2229例。异质性检验χ^(2)=5288.48,P<0.01,I=96.3%,存在高度异质性。如果数据存在高度的异质性,运用随机效应模型对数据进行分析。1.合并效应量为0.241[0.192;0.297],即研究期间,自主循环恢复率为24.1%;2.三个时间段2004至2008年、2009至2013年、2014至2018年自救循环恢复率分别为0.200[0.135;0.286]、0.230[0.147;0.342]、0.281[0.203;0.376],其自救循环恢复率有上升趋势,但三组之间没有统计学差异。结论1.对15年每隔5年时段的院前心肺复苏自救循环恢复率有逐段升高趋势的现象,但无统计学差异。2.心肺复苏在目击下就开始抢救,应在10 min之内,尽早尽快,越快越好。3.用时效规律引领今后的努力方向才是正确的:把急救技术储存在民间,并在公共场所装配AED设备,才能实现最大的抢救潜能。
