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頁籤選單縮合
題 名 | Predictors of Successful Resuscitation in Non-trauma Dead-on-Arrival Children=非外傷性到院前死亡之病童急救成功之預測因素 |
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作 者 | 林晏任; 吳漢屏; 黃靜宜; 張進富; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷 期 | 47:6 民95.11-12 |
頁 次 | 頁278-283+326 |
分類號 | 417.512 |
關鍵詞 | 心跳停止; 到院前死亡; 心肺復甦術; Cardiac arrest; Dead-on-arrival; Cardiopulmonary resuscitation; |
語 文 | 英文(English) |
中文摘要 | 背景:由於急救後的存活率非常地低,於第一線醫療人員而言,對到院前死亡的病童施行急救復甦仍是一個相當艱難的挑戰。在本篇文章裡,我們企盼能找出可以預測急救成功的相關因素。方法:從2000年至2004年這五年間,我們一共收集一百二十位到院前死亡且年齡小於十八歲的病童資料,其中包括了五十九位非外傷性的因素,統整後並加以分析。同時,我們利用存活分析探究非外傷性及外傷性病童在轉送時間上對預後的影響。而Receiver operating characteristic (ROC)曲線分析則用來計算在小兒急診室醫師實施心肺復甦術至少需持續多少時間,才能有意義的提高急救成功率。結果:我們發現到院時的心臟節律型式(P=0.007),是否有實施到院前基本救命術(Basic Life Support)(P<0.001),到院前急救時間的長短(P=0.003),運送病童到院的方式(P=0.019)及運送所花之時間(P=0.025)皆為影響非外傷性到院前死亡之病童急救成功的重要因素。而根據ROC分析結果發現對於非外傷性到院前死亡之病童,在小兒急診室實施心肺復甦術的時間至少需持續二十三分鐘,才有較高的機會使其回復自發性循環。結論:非外傷性到院前死亡之病童急救成功,和幾個因素具有統計上的意義,其中最重要的是在小兒急診室實施心肺復甦術的時間至少需持續二十三分鐘。 |
英文摘要 | Background: Dead-on-arrival (DOA) children pose difficult challenges in resuscitation because of the very low survival rate. In this study, we aimed to analyze the factors that may be related to predicting successful cardiopulmonary resuscitation (CPR). Methods: We reviewed the hospital records of 120 DOA children aged younger than 18 years who had been admitted to the emergency department (ED) from 2000 to 2004 and analyzed related factors that may have influenced initial CPR in the non-trauma DOA children. Survival analysis was used to compare differences in survival rate between the non-trauma and trauma DOA children. Receiver operating characteristic (ROC) analysis was used to determine the predictive in-hospital CPR duration related to success of initial CPR. Results: We found the initial cardiac rhythm (P=0.007), pre-hospital basic life support (BLS) (P<0.001), mode of transportation (P=0.019), the period from scene to hospital (P=0.025) and the duration of pre-hospital BLS (P=0.003) were the significant factors related to initial successful CPR in non-trauma DOA children. Based on the ROC analysis, the cutoff value of in-hospital CPR duration was 23 minutes in non-trauma DOA children. Conclusions: We found that in-hospital CPR should be performed for at least 23 minutes in nontrauma DOA children for spontaneous circulation to return. |
本系統中英文摘要資訊取自各篇刊載內容。