主页 > 医学信息 >
【文摘发布】家用自动体外除颤器用于心脏性猝
Gust H. Bardy, M.D., Kerry L. Lee, Ph.D., Daniel B. Mark, M.D., M.P.H., Jeanne E. Poole, M.D., William D. Toff, M.D., Andrew M. Tonkin, M.D., Warren Smith, M.B., Ch.B., Paul Dorian, M.D., Douglas L. Packer, M.D., Roger D. White, M.D., W.T. Longstreth, Jr., M.D., Jill Anderson, R.N., B.S.N., George Johnson, B.S.E.E., Eric Bischoff, B.A., Julie J. Yallop, Ph.D., Steven McNulty, M.S., Linda Davidson Ray, M.A., Nancy E. Clapp-Channing, R.N., M.P.H., Yves Rosenberg, M.D., Eleanor B. Schron, R.N., Ph.D., for the HAT Investigators
ABSTRACT
Background The most common location of out-of-hospital sudden cardiac arrest is the home, a situation in which emergency medical services are challenged to provide timely care. Consequently, home use of an automated external defibrillator (AED) might offer an opportunity to improve survival for patients at risk.
Methods We randomly assigned 7001 patients with previous anterior-wall myocardial infarction who were not candidates for an implantable cardioverter–defibrillator to receive one of two responses to sudden cardiac arrest occurring at home: either the control response (calling emergency medical services and performing cardiopulmonary resuscitation [CPR]) or the use of an AED, followed by calling emergency medical services and performing CPR. The primary outcome was death from any cause.
Results The median age of the patients was 62 years; 17% were women. The median follow-up was 37.3 months. Overall, 450 patients died: 228 of 3506 patients (6.5%) in the control group and 222 of 3495 patients (6.4%) in the AED group (hazard ratio, 0.97; 95% confidence interval, 0.81 to 1.17; P=0.77). Mortality did not differ significantly in major prespecified subgroups. Only 160 deaths (35.6%) were considered to be from sudden cardiac arrest from tachyarrhythmia. Of these deaths, 117 occurred at home; 58 at-home events were witnessed. AEDs were used in 32 patients. Of these patients, 14 received an appropriate shock, and 4 survived to hospital discharge. There were no documented inappropriate shocks.
Conclusions For survivors of anterior-wall myocardial infarction who were not candidates for implantation of a cardioverter–defibrillator, access to a home AED did not significantly improve overall survival, as compared with reliance on conventional resuscitation methods. (ClinicalTrials.gov number, NCT00047411 [ClinicalTrials.gov] .) 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Home Use of Automated External Defibrillators for Sudden Cardiac Arrest
家用自动体外除颤器用于心脏性猝死
ABSTRACT
摘要
Background The most common location of out-of-hospital sudden cardiac arrest is the home, a situation in which emergency medical services are challenged to provide timely care. Consequently, home use of an automated external defibrillator (AED) might offer an opportunity to improve survival for patients at risk.
背景：院外心脏性猝死发生最多的地点是家里，在这里难以提供及时的急诊医疗服务。因此，家用自动体外除颤器（AED）可能为高危患者提供生存机会。
Methods We randomly assigned 7001 patients with previous anterior-wall myocardial infarction who were not candidates for an implantable cardioverter–defibrillator to receive one of two responses to sudden cardiac arrest occurring at home: either the control response (calling emergency medical services and performing cardiopulmonary resuscitation [CPR]) or the use of an AED, followed by calling emergency medical services and performing CPR. The primary outcome was death from any cause.
方法：我们对7001例有前壁心肌梗死病史，没有植入埋藏式自动复律除颤器，在家里发生过1-2次心跳骤停的患者进行随机分组，对照组（呼叫急诊医疗服务并进行心肺复苏[CPR]）和AED组（使用AED，然后呼叫急诊医疗服务并进行CPR）。主要终点为全因死亡。
Results The median age of the patients was 62 years; 17% were women. The median follow-up was 37.3 months. Overall, 450 patients died: 228 of 3506 patients (6.5%) in the control group and 222 of 3495 patients (6.4%) in the AED group (hazard ratio, 0.97; 95% confidence interval, 0.81 to 1.17; P=0.77). Mortality did not differ significantly in major prespecified subgroups. Only 160 deaths (35.6%) were considered to be from sudden cardiac arrest from tachyarrhythmia. Of these deaths, 117 occurred at home; 58 at-home events were witnessed. AEDs were used in 32 patients. Of these patients, 14 received an appropriate shock, and 4 survived to hospital discharge. There were no documented inappropriate shocks.
结果：患者平均年龄62岁，17％为女性。平均随访37.3个月。一共发生了450例死亡：对照组（3506例）发生了228例死亡（6.5％），AED组（3495例）发生了222例死亡（6.4％）（危险比：0.97；95％可信区间：0.81-1.17；p＝0.77）。各亚组死亡率没有显著差异。仅有160例死亡（35.6％）被认为是快速性心律失常引起的心脏性猝死。对于这些死亡，117例发生在家里，其中58例每人注意到。AED用于32例患者。在这些病人中14例接受了正确的电击，4例生存出院。没有关于不适当电击的记录。
阅读本文的人还阅读：
作者:admin@医学,生命科学 2010-10-27 05:11
医学,生命科学网