麻醉期间心跳骤停常见原因分析演示文稿

麻醉期间心跳骤停常见原因分析演示文稿目前一页\总数十八页\编于十五点优选麻醉期间心跳骤停常见原因分析目前二页\总数十八页\编于十五点目前三页\总数十八页\编于十五点目前四页\总数十八页\编于十五点Japan

Society

of

Anesthesiologists

(JSA)CertifiedTrainingHospitals(CTH)

Atotalnumberof

793,840anestheticsTotalincidenceofcardiacarrestunderanesthesia/surgerywas6.53per10,000anesthetics目前五页\总数十八页\编于十五点principalcauses

oftotalcardiacarrestcasesPC42.9%,IP22.0%SG21.4%AM12.0%(AM:incidencerateof0.78per10,000)(PC)preoperativecomplications(IP)intraoperativepathologicalevents(SG)surgery(AM)anestheticmanagement目前六页\总数十八页\编于十五点In52moredetailedclassification

ofprincipalcausesofcardiacarrestthemostfrequentcause

preoperativehemorrhagicshock,20.3%ofallcardiacarrests.Thesecondcause

massivehemorrhageand/orhypovolemiaduetosurgicalprocedures(13.1%),thethird

cause

intraoperativemyocardialinfarction/coronaryischemia/coronaryspasm(9.5%)目前七页\总数十八页\编于十五点PrognosesofcardiacarrestdeclinedduetoPC:71.1%ofcardiacarrestsdiedinthe

operating

room

orwithin7daysaftersurgeryandonly19.8%survivedwithoutsequelae.ThebestprognosesduetoAM:69.4%survivedwithoutsequelaeand12.9%died.

目前八页\总数十八页\编于十五点the

mortality

rate

post-cardiacarrest3.44per10,000anesthetics,ofthose0.10duetoAM,0.57duetoIP,0.76duetoSG,1.99duetoPC.目前九页\总数十八页\编于十五点

USteachinghospital

13yearsfromtheUniversityofPittsburghMedicalCenter(UPMC)betweenJanuary1,1989toDecember31,2001218274anesthesiacases,including203382generalanesthesiacases,12282spinalanesthesiacases2610epiduralanesthesiacases目前十页\总数十八页\编于十五点intraoperativecardiacarrestfromallcauseswas1.05per10000anestheticsduetoanesthesiaof0.45per100000

(60.8%)diedintheoperatingroom

目前十一页\总数十八页\编于十五点目前十二页\总数十八页\编于十五点目前十三页\总数十八页\编于十五点Characteristics

ofintraoperativecardiacarrest

aremarkablepercentageofpatients(86.9%)whohadintraoperativecardiacarrestwereclassifiedasASAPSIVorV.SurvivalwassignificantlyimprovedinpatientswithASAPSI–III(66.7%)comparedwiththosewithASAPSIV–V(35%).thesurvivalratewaslowerinpatientsolderthan65years(20%)comparedtopatientsyoungerthan64yearsold(53.5%).Asystolewasthemostcommon(52%)oninitialEKGrhythm,andthosepatientsseemedlesslikelytosurviveafterresuscitationcomparedtootherrhythmssuchasPEAandVF;目前十四页\总数十八页\编于十五点Characteristics

ofintraoperativecardiacarrest

Therewasnodifferencebetweenmalesandfemalesinthesurvivalratetherewerenosignificantdifferencesinpatients’survivalrateswithtrauma(50%)oremergencysurgery(42%)comparedwithnon-trauma(36%)orelectivesurgery(36%)目前十五页\总数十八页\编于十五点目前十六页\总数十八页\编于十五点寻找6H/5T，

对寻找可能导致心搏骤停的原因很有帮助目前十七页\总数十八页\编于十五点6H