麻醉期间心跳骤停常见原因分析PPT课件
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• the third cause
• intraoperative myocardial infarction/coronary ischemia/coronary spasm (9.5%)
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Prognoses of cardiac arrest
• declined due to PC: 71.1% of cardiac arrests died in the operating room or within 7 days after surgery and only 19.8% survived without sequelae.
19
感谢亲观看此幻灯片，此课件部分内容来源于网络， 如有侵权请及时联系我们删除，谢谢配合！
anesthesia/surgery was 6.53 per 10,000 anesthetics
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principal causes of total cardiac arrest cases
• PC 42.9%,
• IP 22.0%
• SG 21.4%
• AM 12.0%
(AM:incidence rate of 0.78 per 10,000)
• the survival rate was lower in patients older than 65 years (20%) compared to patients younger than 64 years old (53.5%).
• Asystole was the most common (52%) on initial EKG rhythm, and those patients seemed less likely to survive after resuscitation compared to other rhythms such as PEA and VF;
• the most frequent cause
• preoperative hemorrhagic shock,
• 20.3% of all cardiac arrests.
• The second cause
• massive hemorrhage and/or hypovolemia due to surgical procedures (13.1%),
• a remarkable percentage of patients (86.9%) who had intraoperative cardiac arrest were classified as ASA PS IV or V.
• Survival was significantly improved in patients with ASA PS I–III (66.7%) compared with those with ASA PS IV–V (35%).
• due to anesthesia of 0.45 per 100 000
• (60.8%) died in the operating room
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Characteristics of intraoperative cardiac arrest
• (PC) preoperative complications
• (IP) intraoperative pathological events
• (SG) surgery
• (AM) anesthetic management
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In 52 more detailed classification of principal causes of cardiac arrest
• The best prognoses due to AM: 69.4% survived without sequelae and 12.9% died.
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the mortality rate post-cardiac arrest
• 3.44 per 10,000 anesthetics, • of those 0.10 due to AM,
0.57 due to IP, 0.76 due to SG, 1.99 due to PC.
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US teaching hospital
• 13 years from the University of Pittsburgh Medical Center (UPMC) between January 1, 1989 to December 31, 2001
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5T
• －中毒 toxins • －心包压塞 tamponade ,cardiac • －张力性气胸 tension pneumothorax • －栓塞（冠脉或肺）thrombosis (coronary
or pulmonary) • －创伤 trauma
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Characteristics of intraoperative cardiac arrest
• There was no difference between males and females in the survival rate
• there were no significant differences in patients’ survival rates with trauma (50%) or emergency surgery (42%) compared with non-trauma (36%) or elective surgery (36%)
ppt课件完整
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寻找6H/5T， 对寻找可能导致心搏骤停的原因
很有帮助
ppt课件完整
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6H
• －低血容量 hypovolemia • －低氧血症 hypoxia • －氢离子（酸中毒）hydrogen ion
(acidosis) • －低／高钾血症 hypo-/hyperkalemia • －低血糖 hypoglycemia • －低体温hypothermia
• 218 274 anesthesia cases, including • 203 382 general anesthesia cases, • 12 282 spinal anesthesia cases • 2610 epidural anesthesia cases
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• intraoperative cardiac arrest from all causes was 1.05 per 10 000 anesthetics
术中心跳骤停相关性因素ppt课件完整
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Japan Society of Anesthesiologists (JSA) Certified Training Hospitals (CTH)
• A total number of 793,840 anesthetics • Total incidence of cardiac arrest under
• intraoperative myocardial infarction/coronary ischemia/coronary spasm (9.5%)
ppt课件完整
6
Prognoses of cardiac arrest
• declined due to PC: 71.1% of cardiac arrests died in the operating room or within 7 days after surgery and only 19.8% survived without sequelae.
19
感谢亲观看此幻灯片，此课件部分内容来源于网络， 如有侵权请及时联系我们删除，谢谢配合！
anesthesia/surgery was 6.53 per 10,000 anesthetics
ppt课件完整
4
principal causes of total cardiac arrest cases
• PC 42.9%,
• IP 22.0%
• SG 21.4%
• AM 12.0%
(AM:incidence rate of 0.78 per 10,000)
• the survival rate was lower in patients older than 65 years (20%) compared to patients younger than 64 years old (53.5%).
• Asystole was the most common (52%) on initial EKG rhythm, and those patients seemed less likely to survive after resuscitation compared to other rhythms such as PEA and VF;
• the most frequent cause
• preoperative hemorrhagic shock,
• 20.3% of all cardiac arrests.
• The second cause
• massive hemorrhage and/or hypovolemia due to surgical procedures (13.1%),
• a remarkable percentage of patients (86.9%) who had intraoperative cardiac arrest were classified as ASA PS IV or V.
• Survival was significantly improved in patients with ASA PS I–III (66.7%) compared with those with ASA PS IV–V (35%).
• due to anesthesia of 0.45 per 100 000
• (60.8%) died in the operating room
ppt课件完整
10
ppt课件完整
11
ppt课件完整
12
Characteristics of intraoperative cardiac arrest
• (PC) preoperative complications
• (IP) intraoperative pathological events
• (SG) surgery
• (AM) anesthetic management
ppt课件完整
5
In 52 more detailed classification of principal causes of cardiac arrest
• The best prognoses due to AM: 69.4% survived without sequelae and 12.9% died.
ppt课件完整
7
the mortality rate post-cardiac arrest
• 3.44 per 10,000 anesthetics, • of those 0.10 due to AM,
0.57 due to IP, 0.76 due to SG, 1.99 due to PC.
ppt课件完整
8
US teaching hospital
• 13 years from the University of Pittsburgh Medical Center (UPMC) between January 1, 1989 to December 31, 2001
ppt课件完整
17
5T
• －中毒 toxins • －心包压塞 tamponade ,cardiac • －张力性气胸 tension pneumothorax • －栓塞（冠脉或肺）thrombosis (coronary
or pulmonary) • －创伤 trauma
ppt课件完整
18
ppt课件完整
ppt课件完整
13
Characteristics of intraoperative cardiac arrest
• There was no difference between males and females in the survival rate
• there were no significant differences in patients’ survival rates with trauma (50%) or emergency surgery (42%) compared with non-trauma (36%) or elective surgery (36%)
ppt课件完整
14
ppt课件完整
15
寻找6H/5T， 对寻找可能导致心搏骤停的原因
很有帮助
ppt课件完整
16
6H
• －低血容量 hypovolemia • －低氧血症 hypoxia • －氢离子（酸中毒）hydrogen ion
(acidosis) • －低／高钾血症 hypo-/hyperkalemia • －低血糖 hypoglycemia • －低体温hypothermia
• 218 274 anesthesia cases, including • 203 382 general anesthesia cases, • 12 282 spinal anesthesia cases • 2610 epidural anesthesia cases
ppt课件完整
9
• intraoperative cardiac arrest from all causes was 1.05 per 10 000 anesthetics
术中心跳骤停相关性因素ppt课件完整
3
Japan Society of Anesthesiologists (JSA) Certified Training Hospitals (CTH)
• A total number of 793,840 anesthetics • Total incidence of cardiac arrest under