麻醉期間心跳驟停常見原因分析

關(guān)于麻醉期間心跳驟停常見原因分析第1頁，課件共19頁，創(chuàng)作于2023年2月第2頁，課件共19頁，創(chuàng)作于2023年2月第3頁，課件共19頁，創(chuàng)作于2023年2月Japan

Society

of

Anesthesiologists

(JSA)CertifiedTrainingHospitals(CTH)

Atotalnumberof

793,840anestheticsTotalincidenceofcardiacarrestunderanesthesia/surgerywas6.53per10,000anesthetics第4頁，課件共19頁，創(chuàng)作于2023年2月principalcauses

oftotalcardiacarrestcasesPC42.9%,IP22.0%SG21.4%AM12.0%(AM:incidencerateof0.78per10,000)(PC)preoperativecomplications(IP)intraoperativepathologicalevents(SG)surgery(AM)anestheticmanagement第5頁，課件共19頁，創(chuàng)作于2023年2月In52moredetailedclassification

ofprincipalcausesofcardiacarrestthemostfrequentcause

preoperativehemorrhagicshock,20.3%ofallcardiacarrests.Thesecondcause

massivehemorrhageand/orhypovolemiaduetosurgicalprocedures(13.1%),thethird

cause

intraoperativemyocardialinfarction/coronaryischemia/coronaryspasm(9.5%)第6頁，課件共19頁，創(chuàng)作于2023年2月PrognosesofcardiacarrestdeclinedduetoPC:71.1%ofcardiacarrestsdiedinthe

operating

room

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

第7頁，課件共19頁，創(chuàng)作于2023年2月the

mortality

rate

post-cardiacarrest3.44per10,000anesthetics,ofthose0.10duetoAM,0.57duetoIP,0.76duetoSG,1.99duetoPC.第8頁，課件共19頁，創(chuàng)作于2023年2月

USteachinghospital

13yearsfromtheUniversityofPittsburghMedicalCenter(UPMC)betweenJanuary1,1989toDecember31,2001218274anesthesiacases,including203382generalanesthesiacases,12282spinalanesthesiacases2610epiduralanesthesiacases第9頁，課件共19頁，創(chuàng)作于2023年2月intraoperativecardiacarrestfromallcauseswas1.05per10000anestheticsduetoanesthesiaof0.45per100000

(60.8%)diedintheoperatingroom第10頁，課件共19頁，創(chuàng)作于2023年2月第11頁，課件共19頁，創(chuàng)作于2023年2月第12頁，課件共19頁，創(chuàng)作于2023年2月Characteristics

ofintraoperativecardiacarrest

aremarkablepercentageofpatients(86.9%)whohadintraoperativecardiacarrestwereclassifiedasASAPSIVorV.SurvivalwassignificantlyimprovedinpatientswithASAPSI–III(66.7%)comparedwiththosewithASAPSIV–V(35%).thesurvivalratewaslowerinpatientsolderthan65years(20%)comparedtopatientsyoungerthan64yearsold(53.5%).Asystolewasthemostcommon(52%)oninitialEKGrhythm,andthosepatientsseemedlesslikelytosurviveafterresuscitationcomparedtootherrhythmssuchasPEAandVF;第13頁，課件共19頁，創(chuàng)作于2023年2月Characteristics

ofintraoperativecardiacarrest

Therewasnodifferencebetweenmalesandfemalesinthesurvivalratetherewerenosignificantdifferencesinpatients’survivalrateswithtrauma(50%)oremergencysurgery(42%)comparedwithnon-trauma(36%)orelectivesurgery(36%)第14頁，課件共19頁，創(chuàng)作于2023年2月第15頁，課件共19頁，創(chuàng)作于2023年2月尋找6H/5T，

對尋找可能導(dǎo)致心搏驟停的原因很有幫助第16頁，課件共19頁，創(chuàng)作于2023年2月6H－低血容量hypovolemia－低氧血癥hypoxia－氫離子（酸中毒）hydrogenion(acidosis)－低／高鉀血癥hypo-/hyperkalemia－低血糖hypoglycemia－低體溫hypothermia第17頁，課件共19頁，創(chuàng)作于2023年2月5T－中毒toxins