전문 인명구조술팀에 의해 시행된 병원내 심폐소생술 결과의 In Hospital Utstein Style에 따른 분석 = In-hospital Utstein-style Evaluation of the CPCR Performed by ACLS Teams on Cardiac-arrest patients in a General Hospital

다국어 초록 (Multilingual Abstract)

Purpose: This study assessed the results of the cardiopulmonary-cerebral resuscitation (CPCR) performed by advanced cardiovascular life support (ACLS) teams on cardiac-arrest patients in pundang - jeseang general hospital by using the in hospital Utstein style.
Methods: From march 1999 to February 2001, we collected data based on a formatted protocol by using the in hospital utstein style. The subjects were adult patients over the age of 20 years who had not experienced trauma and who had been resusciated in the hospital (the emergency department (ED), the ward, and intensive care unit, etc.) by an ACLS team. We studied three groups: group Ⅰ (ED), group Ⅱ (general ward), and group Ⅲ (ICU).
Results: among 100,552 patients who were admitted, we resuscitated 152 patients (23 in group Ⅰ, 83 group Ⅱ, 46 group Ⅲ). The number of male patient was higher than the number of female (78%/22%, 57%/43% & 53%/47%). For group Ⅰ, Ⅱ, and Ⅲ, respectively patients between 50 and 70 years of age were predominant, and in all groups, the most witness of the cardiac arrest was the nurse. Performed CPCR methods were complex (87%, 80% & 100%), compression only (4%, 0%, 0%), defibrillation only (9%, 17% & 0%) and ventilation only (0%, 3% & 0%). Initial EKG rhythms were VT/VF (9pts 39%, 44pts 53% & 22pts 48%), PEA (9pts 39%, 23pts 28% & 19pts41%) and asystol (5pts 22%, 16pts 19% & 5pts 11%). The average intervals (minutes) from arrest to CPCR were 0.4±0.4, 3.1±2.2, 1.0±0.6, from arrest to initial defibrillation were 2.7±1.3, 4.0±3.2, 3.0±1.1, from arrest to intubation were 0.5±0.4, 3.8±1.3 & 1.1±1.0 and from arrest to initial epinephrine were 1.4±0.7, 3.0±4.4, 1.5±1.1 The durations of resuscitation minutes were 23.1±22.1, 29.6±13.8, 19.4±14.6 The rates of return of spontaneous circulation were 70% (16/23), 55% (46/83), 77% (34/46). The number of discharged patinets were 3 (13%), 8 (9.6%), 9 (45%). The number of patients alive after 1year were 2 (8.7%), 2 (3.4%), 7 (15.2%).
Conclusion: The rate of return of spontaneous circulation (ROSC) and the number of patinets after 1 year were higher when the resuscitation was performed quickly, and the ACLS team played a great role in this result. Thus, the resuscitation education and training of nurses are very important and should be pursued continuously.

목차 (Table of Contents)

• I. 서론
• II. 대상과 방법
• III. 결과
• 1. 병원변수
• 2. 환자변수
• 1) 성별분포
• 2) 나이별분포 (그림1)
• 3) 심정지시목격여부
• 3. 사건변수
• 1) 초기 심전도소견(표 1)
• 2) 심정지시 시행한 전문 인명구조술기
• 3) 심정지 발생부터 심폐소생술까지 소요된 시간
• 4) 심정지 발생부터 최초 제세동까지 소요된 시간
• 5) 심정지 발생부터 최초 기도확보까지 소요된 시간
• 6) 심정지 발생부터 최초 에피네프린투여까지 소요된 시간
• 7) 순환이 회복된 환자에서 심페소생술의 지속시간
• 8) 자발적 순환회복률 (표 2)
• 4. 예후변수
• 1) Cerebral Performance Category (CPC)
• 2 )생존하여 퇴원한 예
• IV. 고찰
• V. 결론