PDF(Pubmed)
Abstract：
UNASSIGNED: Our goal was to study hypothermic cardiac arrest (CA) patients who were not rewarmed by Extracorporeal Life Support (ECLS) but were admitted to a hospital equipped for it. The focus was on whether the decisions of non-rewarming, meaning termination of resuscitation, were compliant with international guidelines based on serum potassium at hospital admission.
UNASSIGNED: We retrospectively included all hypothermic CA who were not rewarmed, from three Swiss centers between 1st January 2000 and 2nd May 2021. Data were extracted from medical charts and assembled into two groups for analysis according to serum potassium. We identified the criteria used to terminate resuscitation. We also retrospectively calculated the HOPE score, a multivariable tool predicting the survival probability in hypothermic CA undergoing ECLS rewarming.
UNASSIGNED: Thirty-eight victims were included in the study. The decision of non-rewarming was compliant with international guidelines for 12 (33%) patients. Among the 36 patients for whom the serum potassium was measured at hospital admission, 24 (67%) had a value that - alone - would have indicated ECLS. For 13 of these 24 (54%) patients, the HOPE score was <10%, meaning that ECLS was not indicated. The HOPE estimation of the survival probabilities, when used with a 10% threshold, supported 23 (68%) of the non-rewarming decisions made by the clinicians.
UNASSIGNED: This study showed a low adherence to international guidelines for hypothermic CA patients. In contrast, most of these non-rewarming decisions made by clinicians would have been compliant with current guidelines based on the HOPE score.
UNASSIGNED: We retrospectively included all hypothermic CA who were not rewarmed, from three Swiss centers between 1st January 2000 and 2nd May 2021. Data were extracted from medical charts and assembled into two groups for analysis according to serum potassium. We identified the criteria used to terminate resuscitation. We also retrospectively calculated the HOPE score, a multivariable tool predicting the survival probability in hypothermic CA undergoing ECLS rewarming.
UNASSIGNED: Thirty-eight victims were included in the study. The decision of non-rewarming was compliant with international guidelines for 12 (33%) patients. Among the 36 patients for whom the serum potassium was measured at hospital admission, 24 (67%) had a value that - alone - would have indicated ECLS. For 13 of these 24 (54%) patients, the HOPE score was <10%, meaning that ECLS was not indicated. The HOPE estimation of the survival probabilities, when used with a 10% threshold, supported 23 (68%) of the non-rewarming decisions made by the clinicians.
UNASSIGNED: This study showed a low adherence to international guidelines for hypothermic CA patients. In contrast, most of these non-rewarming decisions made by clinicians would have been compliant with current guidelines based on the HOPE score.
摘要：
■我们的目标是研究未通过体外生命支持（ECLS）复温但被送往医院的低温心脏骤停（CA）患者。重点是不复温的决定，意味着复苏的终止，符合入院时基于血清钾的国际指南。
■我们回顾性地纳入了所有未复温的低体温CA，从2000年1月1日至2021年5月2日之间的三个瑞士中心。从医学图表中提取数据，并根据血清钾分为两组进行分析。我们确定了终止复苏的标准。我们还回顾性地计算了HOPE评分，一种多变量工具，可预测接受ECLS复温的低体温CA患者的生存概率。
■38名受害者被纳入研究。不复温的决定符合12名（33％）患者的国际指南。在入院时测量血清钾的36例患者中，24（67%）的值-单独-就表明ECLS。对于这24名患者中的13名（54%），希望得分<10%,这意味着没有指示ECLS。生存概率的希望估计，当与10%的阈值一起使用时，支持23(68%)临床医生做出的不复温决定.
■这项研究表明，低体温CA患者对国际指南的依从性较低。相比之下,临床医生做出的这些不复温决定中的大多数符合基于HOPE评分的现行指南.
■我们回顾性地纳入了所有未复温的低体温CA，从2000年1月1日至2021年5月2日之间的三个瑞士中心。从医学图表中提取数据，并根据血清钾分为两组进行分析。我们确定了终止复苏的标准。我们还回顾性地计算了HOPE评分，一种多变量工具，可预测接受ECLS复温的低体温CA患者的生存概率。
■38名受害者被纳入研究。不复温的决定符合12名（33％）患者的国际指南。在入院时测量血清钾的36例患者中，24（67%）的值-单独-就表明ECLS。对于这24名患者中的13名（54%），希望得分<10%,这意味着没有指示ECLS。生存概率的希望估计，当与10%的阈值一起使用时，支持23(68%)临床医生做出的不复温决定.
■这项研究表明，低体温CA患者对国际指南的依从性较低。相比之下,临床医生做出的这些不复温决定中的大多数符合基于HOPE评分的现行指南.
