ECG patterns in early pulseless electrical activity-Associations with aetiology and survival of in-hospital cardiac arrest

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• 作者：Daniel Bergum^a ; ^b ; ^d ; ^{daniel.bergum@ntnu.no" class="auth_mail" title="E-mail the corresponding author} ; Gunnar Waage Skjeflo^a ; Trond Nordseth^b ; Ole Christian Mjø ; lstad^a ; ^c ; Bjø ; rn Olav Haugen^a ; ^c ; Eirik Skogvoll^a ; ^b ; Jan På ; l Loennechen^a ; ^c
• 关键词：Cardiac arrest ; Pulseless electrical activity ; Causes ; Aetiology ; Defibrillator ; Resuscitation
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：104
• 期：Complete
• 页码：34-39
• 全文大小：1005 K

文摘

Pulseless electrical activity (PEA) is an increasingly common presentation in cardiac arrest. The aim of this study was to investigate possible associations between early ECG patterns in PEA and the underlying causes and survival of in-hospital cardiac arrest (IHCA).

Methods

Prospectively observed episodes of IHCA presenting as PEA between January 2009 and august 2013, with a reliable cause of arrest and corresponding defibrillator ECG recordings, were analysed. QRS width, QT interval, Bazett's corrected QT interval, presence of P waves and heart rate (HR) was determined. QRS width and HR were considered to be normal below 120 ms and within 60–100 cardiac cycles per minute, respectively.

Results

Fifty-one episodes fulfilled the inclusion criteria. The defibrillator was attached after a median of one minute (75th percentile; 3 min) after the onset of arrest. Ninety percent (46/51) had widened QRS complexes, 63% (32/51) were defined as ‘wide-slow’ due to QRS-widened bradycardia, and only 6% (3/51) episodes were categorized as normal. No unique cause-specific ECG pattern could be identified.

Further 7 episodes with a corresponding defibrillator file, but without a reliable cause, were included in analysis of survival. Abnormal ECG patterns were seen in all survivors. None of the patients with ‘normal’ PEA survived.

Conclusion

Abnormal ECG patterns were frequent at the early stage of in-hospital PEA. No unique patterns were associated with the underlying causes or survival.