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2015, vol. 1, br. 2, str. 9-13
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EURECA one 2014 - analiza povratka spontane cirkulacije (ROSC)
EURECA One 2014: ROSC analysis
Sažetak
UVOD: Stopa preživljavanja srčanog zastoja kod vanbolničkih kardiopulmonalnih reanimacija je niska, iznosi od 1,7 do 6,1%. Povratak spontane cirkulacije ( ROSC ) je prvi korak ka potpunom oporavku bolesnika nakon srčanog zastoja. Prediktori održivog ROSC-a su osvedočenost kolapsa od strane svedoka, početni srčani ritam, započeta kardiopulmonalna reanimacija od strane očevidaca, rani izlazak hitne medicinske pomoći (EMS), rana defibrilacija i kratko trajanje sanitetskog transporta. CILJ: Istražiti povratak spontane cirkulacije (ROSC) po epidemiološkim, demografskim karakteristikama, tretmanu i ishodu (preživljavanje nakon mesec dana) sa šokabilnim inicijalnim ritmom na šestomesečnom uzorku. METOD: Prospektivna, opservaciona studija prikupljanje podataka po jedinstvenom upitniku, koji se odnosi na vanbolnički srčani zastoj u vremenskom periodu od 1. oktobra 2014. do 31. marta 2015. godine na teritoriji Vojvodine. Korišteni su podaci koji su registrovani u bazi podataka evropskog programa EuReCa One 2014. REZULTATI Analizirano 276 bolesnika sa vanbolničkim srčanim zastojem na teritoriji Vojvodine - incidenca 40,63/100000. Kardiopulmonalna reanimacija od strane hitnih medicinskih pomoći je započeta kod 56,16% (N=155, n=22, 82/100000), spontana cirkulacija (ROSC) uspostavljena u 30,32% (N= 47 n=6,92/100000), a preživljavanje nakon 30 dana 9,03% ( N= 14, n=2,06/100000). Inicijalni šokabilni ritam se registrovao kod 59,57 % pacijenata ( N= 28, n= 4,10 / 100000 ). ZAKLJUČAK: Primarni cilj kardiopulmonalne reanimacije je povratak spontane cirkulacije (ROSC), koja zavisi od ključnih faktora koji utiču na tok kardiopulmonalne reanimacije, a kao pozitivne varijable su inicijalni šokabilni ritam, osvedočenost srčanog zastoja od strane svedoka-laika ili hitne medicinske pomoći, pretpostavljeni uzrok srčano obolenje, ženski pol i starost pacijenta ispod 80 godina.
Abstract
INTRODUCTION Cardiac arrest survival rate after out of hospital cardiopulmonary resuscitations is pretty low and goes from 1,7% to 6,1%. The return of spontaneous circulation is the first step towards complete recovery of the patient after experiencing cardiac arrest. Predictors of sustainable ROSC include witnessing of collapse by laymen, initial heart rhythm, bystander initiation of CPR, early EMS engagement, early defibrillation and short duration of medical transport. AIM: It is to investigate the return of ROSC in regards to epidemiological and demographic characteristics, treatment and outcome (survival after a month) with shockable initial rhythm for a six-month sample. METHOD: Prospective observational study where data were gathered through particular questionnaire that concerned OHCA (out-of-hospital cardiac arrest) on the territory of Vojvodina during six month period (from October 1st 2104. until March 31st 2015.). The data that were used are registered in the data base of European programme EuReCA One 2014. RESULTS: 276 patients that have had OHCA on the territory of Vojvodina were analyzed - the incidence of 40,63 per 100 000. EMS conducted CPR in 51,16% (N=155, n=22,82/100 000), ROSC was established in 30,32% (N=47, n=6,92/100 000), and 30 days survival was documented in 9,03% of the cases (N=14, n=2,06/100 000). Shockable rhythm was initially recognized with 59,57% of the patients (N=28, n=4,10/100 000). CONCLUSION: Cardiopulmonary resuscitation sets the return of spontaneous circulation (ROSC) as its primary objective, which depends great deal on key factors affecting the course of CPR, and positive variables for CPR course are initial shockable rhythm, witnessing of cardiac arrest by layman or EMS, heart condition as the presumed cause, female gender and age under 80 years.
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