Avtor/Urednik		Špindler, Mateja; Grmec, Štefek
Naslov		Utstein analiza kardiopulmonalnega oživljanja v predbolnišničnem okolju: temeljni postopki oživljanja in PETCO[spodaj]2
Prevedeni naslov		Utstein style analysis of out-of-hospital cardiac arrest - bystander cardiopulmonary resuscitation and end-tidal carbon dioxide partial pressure
Tip		članek
Vir		In: Grmec Š, Kupnik D, editors. Akutna stanja. Maribor: Zdravstveni dom dr. Adolfa Drolca, Center za nujno medicinsko pomoč in reševalne prevoza,
Leto izdaje		2007
Obseg		str. 276-89
Jezik		slo
Abstrakt		Introduction. The aim of this prospective cohort study was to describe the outcome for patients with out-of-hospital cardiac arrest in Maribor (Slovenia) over a 4 year period using a modified Utstein style, and to investigate elementary knowledge of basic life support among potential bystanders in our community. Patients and methods. Through the prehospital and the hospital database system we followed up a consecutive group of patients with out-of-hospital cardiac arrest (OHCA) between January 2001 and December 2004. We investigated the effects of various factors on outcome in OHCA, especially partial end-tidal CO2 pressure (petCO2), efficacy of bystander CPR and their elementary knowledge of basic life support (BLS). We also examined motivation among potential bystanders and possible implementation for BLS education in our community. Results. OHCA was confirmed in 592 patients. Advanced cardiac life support was initiated in 389 patients, of which 277 were of cardiac etiology. In 287 patients the event was bystanders witnessed and lay-bystander basic life support was performed only in 83 (23 %). After treating OHCA by a physician-based prehospital medical team ROSC was obtained in 61 %, the ROSC on admission was 50 % and the overall survival to discharge was 21 %. Initial petCO2, ventricular fibrillation or pulseless ventricular tachycardia as initial rhytm, bystander CPR, female sex and arrival time were associated with improved ROSC when using multivariate analysis. Using the same method we found that bystander CPR, witnessed arrest, final petCO2, initial petCO2 and arrival time were associated with improved survival. A questionnaire to potential bystanders has revealed disappointing knowledge about BLS fundamentals. On the other side, there is a welcomed willingness of potential bystanders to take BLS training and to follow dispatchers instructions by telephone on how to perform CPR. Conclusion. (Abstract truncated at 2000 characters)
Izvleček		Izhodišča. Namen naše prospektivne kohortne študije je bilo ugotavljanje izhoda (preživetja in kakovosti življenja) pri bolnikih, pri katerih je prišlo do srčnega zastoja v izvenbolnišničnem okolju (out-of-hospital cardiac arrest - OHCA) na področju Maribora v obdobju zadnjih štirih let. Podatke smo analizirali po Utstein protokolu. Izvedli smo tudi raziskavo o znanju temeljnih postopkov oživljanja pri laikih v naši skupnosti. Bolniki in metode. Bolnike z OHCA in po uspešnem oživljanju smo sledili s pomočjo podatkovnega sistema v naši predbolnišnični enoti in s pomočjo bolnišnične baze podatkov. Podatke smo zbirali za obdobje od januarja 2001 do decembra 2004. Zanimal nas je učinek različnih dejavnikov na izhod po oživljanju, še posebej vrednost delnega tlaka ogljikovega dioksida ob koncu izdiha (partial end-tidal CO2 pressure - petCO2), učinkovitost in znanje izvajanja temeljnih postopkov oživljanja (TPO) s strani laikov - očividcev ter želja in motivacija po učenju TPO s strani laikov v naši skupnosti. Rezultati. Vseh bolnikov z OHCA je bilo v obdobju od januarja 2001 do decembra 2004 592. Dodatne postopke oživljanja (DPO) smo izvajali (ekipa nujne medicinske pomoči - NMP) pri 389 bolnikih. Pri 277 je bil vzrok za srčni zastoj zastoj srčne etiologije. Pri 287 bolnikih je prišlo do kolapsa in srčnega zastoja vpričo laikov, a le pri 83 (23 %) bolnikih so laiki-očividci izvajali TPO. Po oživljanju bolnikov z OHCA, ki ga je izvajala ekipa NMP (v ekipi je tudi zdravnik), je prišlo do povrnitve spontanega krvnega obtoka (Return of Spontaneous Circulation - ROSC) pri 61 % bolnikov. Pri 50 % bolnikov sta bila spontana srčna akcija in krvni obtok prisotna ob sprejetju v bolnišnico. 21 % bolnikov je bilo odpuščenih iz bolnišnice. (Izvl. skrajšan na 2000 zn.)
Deskriptorji		RESUSCITATION CARDIOPULMONARY RESUSCITATION BLOOD GAS MONITORING, TRANSCUTANEOUS CARBON DIOXIDE TREATMENT OUTCOME SURVIVAL RATE