PDF(Pubmed)
Abstract：
Background: The search for the best therapeutic approach in cardiopulmonary resuscitations (CPR) remains open to question. In this study, we evaluated if Amiodarone administration during CPR was associated with short-term mortality or neurological development. Methods: A total of 232 patients with sudden cardiac arrest (CA) with shockable rhythms were included in our analysis. Propensity score matching based on age, gender, type of CA, and CPR duration was used to stratify between patients with and without Amiodarone during CPR. Primary endpoints were short-term mortality (30-day) and neurological outcomes assessed by the cerebral performance category. Secondary endpoints were plasma lactate, phosphate levels at hospital admission, and the peak Neuron-specific enolase. Results: Propensity score matching was successful with a caliper size used for matching of 0.089 and a sample size of n = 82 per group. The 30-day mortality rates were similar between both groups (p = 0.24). There were no significant differences in lactate levels at hospital admission and during the following five days between the groups. Patients receiving Amiodarone showed slightly higher phosphate levels at hospital admission, while the levels decreased to a similar value during the following days. Among CA survivors to hospital discharge, no differences between the proportion of good neurological outcomes were detected between the two groups (p = 0.58), despite slightly higher peak neuron-specific enolase levels in CA patients receiving Amiodarone (p = 0.03). Conclusions: Amiodarone administration is not associated with short-term mortality or neurological outcomes in CA patients with shockable rhythms receiving CPR.
摘要：
背景：在心肺复苏（CPR）中寻找最佳治疗方法仍然存在疑问。在这项研究中,我们评估了CPR期间使用胺碘酮是否与短期死亡率或神经系统发育相关.方法：我们共纳入232例有可电击节律的心脏骤停（CA）患者。基于年龄的倾向得分匹配，性别,CA的类型,和CPR持续时间用于在CPR期间对有和没有胺碘酮的患者进行分层。主要终点是短期死亡率（30天）和通过脑表现类别评估的神经系统结局。次要终点是血浆乳酸，入院时的磷酸盐水平，和神经元特异性烯醇化酶的峰值。结果:倾向评分匹配是成功的,用于匹配的卡尺尺寸为0.089,样本尺寸为每组n=82。两组的30天死亡率相似（p=0.24）。入院时和接下来的五天内，两组之间的乳酸水平没有显着差异。接受胺碘酮的患者入院时磷酸盐水平略高，而在接下来的几天里，水平下降到类似的值。在出院的CA幸存者中，两组间神经系统预后良好的比例无差异(p=0.58),尽管接受胺碘酮的CA患者的神经元特异性烯醇化酶峰值水平略高（p=0.03）。结论：胺碘酮的给药与接受CPR的具有可电击节律的CA患者的短期死亡率或神经系统预后无关。
