- 期刊
Outcome of Out-of-hospital Cardiac Arrest in Preschool Children
學齡前兒童到院前心臟停止之預後
摘要
背景：本文探討學齡前兒童到院前心臟停止之預後及影響預後之因素。 方法：本文回溯性蒐集在6.1年中送至中台灣某醫學中心，小於六歲，於急診就診時呼吸心跳停止之病人。分析病人之特徵及影響預後之因素。 結果：從1999年一月至2005年二月總共有60位病人送至急診時無脈搏並接受急救。其中41位(68%)於急診死亡；19位(32%)住進加護病房。影響病人存活至住進加護病房治療之因素為在急診時接受較短時間之急救及給予較少劑量之腎上腺素。只有兩位病人(3%)存活至出院，此兩位病人均有嚴重之神經後遺症。 結論：到院前心臟停止之學齡前兒童之預後非常差。在急診時接受較短時間之急救及較少劑量之腎上腺素為影響病人能否存活至住院之最重要關鍵。長時間的急救對學齡前到院前心臟停止之兒童並沒有幫助。
並列摘要
Background: Determine the survival rate among children after out-of-hospital cardiac arrest (OHCA) and identify predictors of survival. Methods: This is a retrospective study over a 6.1-year period at a medical center in central Taiwan. Children younger than 6 years old with apnea and no palpable pulse who presented to the emergency department (ED) were enrolled in a chart review. The characteristics of the patients and the outcomes of illness were analyzed. Results: From January 1999 to February 2005, 58 young children who came to the ED without a palpable pulse were enrolled in our study. Thirty-nine patients (68%) had no return of spontaneous circulation (ROSC) in the ED and 19 patients (32%) had a ROSC and were admitted to the ICU. Factors that predicted ROSC included a short interval from starting cardiopulmonary resuscitation (CPR) to ROSC in the ED and the administration of fewer doses of epinephrine in the ED. Only 2 patients (3%) survived to hospital discharge, and both had neurologic sequelae. Conclusions: These results suggest that OHCA among young children has a very poor prognosis. A shorter interval from starting CPR to ROSC and administration of fewer doses of epinephrine in the ED were the main factors predicting survival to hospital admission. Prolonged CPR can not increase the survival rate in preschool OHCA children.