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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Survival and Cardiopulmonary Resuscitation Hemodynamics Following Cardiac Arrest in Children With Surgical Compared to Medical Heart Disease*
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Survival and Cardiopulmonary Resuscitation Hemodynamics Following Cardiac Arrest in Children With Surgical Compared to Medical Heart Disease*

机译：外科医生疾病与外科手术心脏捕捞后心脏骤停的生存和心肺复苏血液动力学*

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Objectives: To assess the association of diastolic blood pressure cutoffs (>= 25 mm Hg in infants and >= 30 mm Hg in children) during cardiopulmonary resuscitation with return of spontaneous circulation and survival in surgical cardiac versus medical cardiac patients. Secondarily, we assessed whether these diastolic blood pressure targets were feasible to achieve and associated with outcome in physiology unique to congenital heart disease (single ventricle infants, open chest), and influenced outcomes when extracorporeal cardiopulmonary resuscitation was deployed. Design: Multicenter, prospective, observational cohort analysis. Setting: Tertiary PICU and cardiac ICUs within the Collaborative Pediatric Critical Care Research Network. Patients: Patients with invasive arterial catheters during cardiopulmonary resuscitation and surgical cardiac or medical cardiac illness category. Interventions: None. Measurements and Main Results: Hemodynamic waveforms during cardiopulmonary resuscitation were analyzed on 113 patients, 88 surgical cardiac and 25 medical cardiac. A similar percent of surgical cardiac (51/88; 58%) and medical cardiac (17/25; 68%) patients reached the diastolic blood pressure targets (p = 0.488). Achievement of diastolic blood pressure target was associated with improved survival to hospital discharge in surgical cardiac patients (p = 0.018), but not medical cardiac patients (p = 0.359). Fifty-three percent (16/30) of patients with single ventricles attained the target diastolic blood pressure. In patients with an open chest at the start of chest compressions, 11 of 20 (55%) attained the target diastolic blood pressure. In the 33 extracorporeal cardiopulmonary resuscitation patients, 16 patients (48%) met the diastolic blood pressure target with no difference between survivors and nonsurvivors (p = 0.296). Conclusions: During resuscitation in an ICU, with invasive monitoring in place, diastolic blood pressure targets of greater than or equal to 25 mm Hg in infants and greater than or equal to 30 mm Hg in children can be achieved in patients with both surgical and medical heart disease. Achievement of diastolic blood pressure target was associated with improved survival to hospital discharge in surgical cardiac patients, but not medical cardiac patients. Diastolic blood pressure targets were feasible to achieve in 1) single ventricle patients, 2) open chest physiology, and 3) extracorporeal cardiopulmonary resuscitation patients.
机译：目的：在心肺复苏期间，评估舒张压抑制（> = 25mm Hg的婴儿和> = 30毫米Hg）的关联，并在外科心脏与医用心脏病患者中的自发循环和存活率进行恢复。其次，我们评估了这些舒张血压靶标的是否可行，并且在部署体外心肺复苏时，与先天性心脏病（单一性心室婴儿，开口胸部）和受影响的结果有关的生理学的结果。设计：多中心，前瞻性，观察队列分析。设置：合作小儿关键护理研究网络中的三级PICU和心脏病ICU。患者：心肺复苏和外科心脏病或医用心脏病类别的侵袭性动脉导管患者。干预措施：没有。测量和主要结果：在113名患者，88例外科心脏和25例医疗心脏上分析了心肺复苏期间的血流动力波形。类似的手术心脏（51/88; 58％）和医学心脏（17/25; 68％）患者的百分比达到舒张压靶标（P = 0.488）。舒张压毒性的成就与手术心脏病患者的医院排放的提高生存有关（P = 0.018），但不是医用心脏患者（P = 0.359）。患有单个脑室的患者的五十三（16/30）达到靶舒张压。在胸部按压开始的胸部患者中，11种20（55％）达到目标舒张压。在33例体外心肺复苏患者中，16名患者（48％）达到舒张压症，幸存者和非尿道之间没有差异（p = 0.296）。结论：在ICU的复苏期间，在手术和医疗的患者中，患有侵袭性监测的侵袭性监测，婴儿大于或等于25 mm Hg的舒张压症心脏疾病。舒张压症的成就与手术心脏病患者的病院排放的提高生存有关，但不是医用心脏病患者。舒张压靶标是在1岁的单一脑室患者中实现的可行性，2）开放性胸部生理学，3）体外心肺复苏患者。

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