3 차 병원의 병동에서 시행된 심폐소생술의 분석

Background: Although cardiopulmonary resuscitation (CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation (ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases (65.2%) of asystole, 14(30.4%) of PEA (pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases (56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases (13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.