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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >An evaluation of pediatric in-hospital advanced life support interventions using the pediatric Utstein guidelines: a review of 203 cardiorespiratory arrests: (Une evaluation des interventions de reanimation cardiorespiratoire avancee en pediatrie hos
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An evaluation of pediatric in-hospital advanced life support interventions using the pediatric Utstein guidelines: a review of 203 cardiorespiratory arrests: (Une evaluation des interventions de reanimation cardiorespiratoire avancee en pediatrie hos

机译：使用儿科的Utstein指南评估儿科住院高级生命支持干预措施：对203例心肺骤停的回顾：（对评估复活的心肺复苏术进行评估）

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PURPOSE: Evaluate the efficacy of advanced life support interventions using the pediatric Utstein guidelines. METHODS: Charts from all patients for whom a cardiorespiratory arrest code was called during a six-year period in a university affiliated centre were reviewed. Data were recorded according to the pediatric Utstein guidelines and a P < 0.05 was considered significant. RESULTS: Of the 234 calls, 203 were retained for analysis. The overall survival rate at one year was 26.0% of which 10% had deterioration of their neurologic status compared to the pre-cardiorespiratory arrest evaluation. Time to achieve sustained return of spontaneous circulation (ROSC; P < 0.0001) and sustained measurable blood pressure (P = 0.002), to perform endotracheal intubation (P = 0.04) and the dose of sodium bicarbonate (P < 0.0001) were indicators of long-term survival. Two patients were alive at one year with unchanged neurologic status despite a time to achieve sustained ROSC longer than 30 min (38 and 44 min). The mean first epinephrine dose of patients for whom ROSC was achieved but unsustained was higher than those for whom ROSC was achieved and sustained (0.038 +/- 0.069 mg*kg(-1) vs 0.011 +/- 0.006 mg*kg(-1); P = 0.004). Survival rate and mean first epinephrine dose of patients who received their first epinephrine dose endotracheally (13.3%; 0.011 +/- 0.004 mg*kg(-1)) were comparable to those of patients who received their first epinephrine dose intravenously (7%; 0.015 +/- 0.027 mg*kg(-1)). CONCLUSIONS: For intravenously administered epinephrine, a dose of 0.01 mg*kg(-1) seems appropriate as the first dose. The endotracheal route is a valuable alternative for epinephrine administration and, for infants, the dose does not need to be increased. A minimal resuscitation duration time of 30 min can be misleading if ROSC is used as the indicator.
机译：目的：使用儿科的Utstein指南评估先进的生命支持干预措施的疗效。方法：回顾了在大学附属中心的六年中被呼叫心肺骤停代码的所有患者的图表。根据儿童Utstein指南记录数据，P <0.05被认为是显着的。结果：在234个呼叫中，保留了203个以进行分析。与心肺骤停前的评估相比，一年的总生存率为26.0％，其中10％的神经系统状态恶化。实现持续自发性循环恢复（ROSC; P <0.0001）和持续可测血压（P = 0.002），进行气管插管（P = 0.04）和碳酸氢钠剂量（P <0.0001）的时间长长期生存。尽管有一段持续时间超过30分钟（38和44分钟）的持续ROSC，但两名患者在一年时还活着，神经系统状况没有改变。获得ROSC但未持续的患者的第一肾上腺素平均剂量高于获得并持续ROSC的患者（0.038 +/- 0.069 mg * kg（-1）vs 0.011 +/- 0.006 mg * kg（-1 ）; P = 0.004）。气管内首次接受肾上腺素剂量的患者的生存率和平均首次肾上腺素剂量（13.3％; 0.011 +/- 0.004 mg * kg（-1））与静脉内接受首次肾上腺素剂量的患者（7％; 0.015 +/- 0.027 mg * kg（-1））。结论：对于静脉内给予肾上腺素，0.01 mg * kg（-1）的剂量似乎是合适的第一剂量。气管内途径是肾上腺素给药的一种有价值的替代方法，对于婴儿，不需要增加剂量。如果将ROSC用作指标，则最短的30分钟复苏持续时间可能会产生误导。

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