院前心脏停搏的高级生命支持

• 作者: GeorgeA.Wells IanG.Stiell 宋康兴
• 来源期刊: 世界急危重病医学杂志
• 学科: 医学
• 关键词: d-d 院前 高级生命支持 心脏停搏
• 年，卷（期）: 2005,（1）
• 页码范围: 545-548
• 页数: 4页
• 分类号: R541

摘要

Background The Ontario Prehospital Advanced Life Support (OPALS) Study tested the incremental effect on the rate of survival after out-of-hospital cardiac arrest of adding a program of advanced life support to a program of rapid defibrillation. Methods This multicenter, controlled clinical trial was conducted in 17 cities before and after advanced-life- support programs were instituted and enrolled 5 638 patients who had had cardiac arrest outside the hospital. Of those patients, 1 391 were enrolled during the rapid-defibrillation phase and 4 247 during the subsequent advanced-life-support phase. Paramedics were trained in standard advanced life support, which includes endotracheal intubation and the administration of intravenous drugs. Results From the rapid-defibrillation phase to the advanced-life-support phase, the rate of admission to a hospital increased significantly (10.9 percent vs.14.6 percent, P<0.001), but the rate of survival to hospital discharge did not (5.0 percent vs. 5.1 percent,P=0.83). The multivariate odds ratio for survival after advanced life support was 1.1 (95 percent confidence interval, 0.8 to 1.5); after an arrest witnessed by a bystander, 4.4 (95 percent confidence interval, 3.1 to 6.4); after cardiopulmonary resuscitation administered by a bystander, 3.7 (95 percent confidence interval,2.5 to 5.4); and after rapid defibrillation, 3.4 (95 percent confidence interval, 1.4 to 8.4). There was no improvement in the rate of survival with the use of advanced life support in any subgroup. Conclusions The addition of advanced-life-support interventions did not improve the rate of survival after out-of-hospital cardiac arrest in a previously optimized emergency-medical-services system of rapid defibrillation. In order to save lives, health care planners should make cardio- pulmonary resuscitation by citizens and rapiddefibrillation responses a priority for the resources of emergency-medical-services systems.

作者信息

序号	姓名	单位	发文数	被引次数	H指数	G指数
1	IanG.Stiell	安大略院前高级生命支持研究组	1	0	0.0	0.0
2	GeorgeA.Wells	安大略院前高级生命支持研究组	1	0	0.0	0.0
3	宋康兴	安大略院前高级生命支持研究组	1	0	0.0	0.0