期刊
RESUSCITATION
卷 85, 期 3, 页码 336-342出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2013.10.014
关键词
Cardiopulmonary resuscitation; Heart arrest; Resuscitation; Survival
资金
- University of Washington Data Coordinating Center from the National Heart, Lung and Blood Institute [5U01 HL077863]
- Medical College of Wisconsin from the National Heart, Lung and Blood Institute [HL077866]
- University of Washington from the National Heart, Lung and Blood Institute [HL077867]
- University of Pittsburgh from the National Heart, Lung and Blood Institute [HL077871]
- St. Michael's Hospital from the National Heart, Lung and Blood Institute [HL077872]
- Oregon Health and Science University from the National Heart, Lung and Blood Institute [HL077873]
- University of Alabama at Birmingham from the National Heart, Lung and Blood Institute [HL077881]
- Ottawa Hospital Research Institute from the National Heart, Lung and Blood Institute [HL077885]
- University of Texas SW Medical Ctr/Dallas from the National Heart, Lung and Blood Institute [HL077887]
- University of California San Diego from the National Heart, Lung and Blood Institute [HL077908]
- National Institute of Neurological Disorders and Stroke
- U.S. Army Medical Research & Material Command
- Canadian Institutes of Health Research (CIHR) - Institute of Circulatory and Respiratory Health
- Defence Research and Development Canada
- Heart, Stroke Foundation of Canada
- American Heart Association
Background: Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of-hospital shockable cardiac arrest (OHCA). Objective: To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. Methods: We included patients in the ROC PRIMED trial who suffered OHCA between June 2007 and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Results: Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15 s (8, 22); post-shock pause 6 s (4, 9); and peri-shock pause 22.0 s (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10 s (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause <20 s (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause >= 20 s and peri-shock pause >= 40 s. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score <= 3) were similar to our primary outcome. Conclusions: In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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