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首页> 外文期刊>Sao Paulo Medical Journal >Frequency of intraoperative cardiac arrest and medium-term survival
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Frequency of intraoperative cardiac arrest and medium-term survival

机译：术中心脏骤停的频率和中期生存

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CONTEXT AND OBJECTIVE: Although advances in surgical and anesthetic techniques have reduced perioperative morbidity-mortality, the survival rate following cardiac arrest remains low. The aim of this study was to evaluate, over the course of one year, the prevalence of intraoperative cardiac arrest and the 30-day survival rate after this event in a tertiary teaching hospital. DESIGN AND SETTING: Prospective cohort study in a tertiary teaching hospital. METHODS: Following approval by the institutional ethics committee, anesthetic procedures and cases of intraoperative cardiac arrest between January and December 2007 were evaluated. Patients undergoing cardiac surgery were excluded. The data were gathered prospectively using the modified Utstein model, with evaluation of demographic data, pre-arrest conditions, intraoperative care, care during arrest and postoperative outcome up to the 30th day. The data were recorded by the attending anesthesiologist. RESULTS: During the study period, 40,379 anesthetic procedures were performed, and 52 cases of intraoperative cardiac arrest occurred (frequency of 13:10,000). Among these, 69% presented spontaneous return of circulation after the initial arrest, and only 25% survived for 30 days after the event. The following factors were associated with shorter survival: American Society of Anesthesiologists physical status IV and V, emergency surgery, hemorrhagic events, hypovolemia as the cause of arrest and use of atropine during resuscitation. CONCLUSIONS: Although the frequency of cardiac arrest in the surgical environment has declined and resources to attend to this exist, the survival rate is low. Factors associated with worst prognosis are more frequent in critical patients.
机译：背景与目的：尽管外科手术和麻醉技术的进步已降低围手术期的死亡率，但心脏骤停后的存活率仍然很低。这项研究的目的是评估在三级教学医院中术中心脏骤停的发生率以及该事件发生后30天生存率。设计与环境：在一家三级教学医院进行前瞻性队列研究。方法：经机构伦理委员会批准，对麻醉程序和2007年1月至12月间术中心脏骤停的病例进行了评估。排除接受心脏手术的患者。使用改良的Utstein模型前瞻性收集数据，并评估人口统计学数据，逮捕前状况，术中护理，逮捕期间的护理以及直至30天的术后结果。数据由主治麻醉师记录。结果：在研究期间，进行了40,379例麻醉手术，并发生52例术中心脏骤停（频率13：10,000）。其中，有69％的人在最初被捕后表现出自发的血液循环，只有25％的人在事件发生后存活了30天。以下因素与生存期缩短有关：美国麻醉医师学会IV和V的身体状况，急诊手术，出血事件，血容量不足是引起逮捕的原因，并且在复苏过程中使用了阿托品。结论：尽管在外科手术环境中心脏骤停的频率有所下降，并且存在解决这一问题的资源，但其存活率很低。重症患者中与最差预后相关的因素更为常见。

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