麻醉期间心跳骤停常见原因分析ppt课件

麻醉期间心跳骤停常见原因分析 1 术中心跳骤停相关性因素分析 麻醉期间心跳骤停常见原因分析 2 麻醉期间心跳骤停常见原因分析 3 麻醉期间心跳骤停常见原因分析 4 JapanSocietyofAnesthesiologists JSA CertifiedTrainingHospitals CTH Atotalnumberof793 840anestheticsTotalincidenceofcardiacarrestunderanesthesia surgerywas6 53per10 000anesthetics 麻醉期间心跳骤停常见原因分析 5 principalcausesoftotalcardiacarrestcases PC42 9 IP22 0 SG21 4 AM12 0 AM incidencerateof0 78per10 000 PC preoperativecomplications IP intraoperativepathologicalevents SG surgery AM anestheticmanagement 麻醉期间心跳骤停常见原因分析 6 In52moredetailedclassificationofprincipalcausesofcardiacarrest themostfrequentcausepreoperativehemorrhagicshock 20 3 ofallcardiacarrests Thesecondcausemassivehemorrhageand orhypovolemiaduetosurgicalprocedures 13 1 thethirdcauseintraoperativemyocardialinfarction coronaryischemia coronaryspasm 9 5 麻醉期间心跳骤停常见原因分析 7 Prognosesofcardiacarrest declinedduetoPC 71 1 ofcardiacarrestsdiedintheoperatingroomorwithin7daysaftersurgeryandonly19 8 survivedwithoutsequelae ThebestprognosesduetoAM 69 4 survivedwithoutsequelaeand12 9 died 麻醉期间心跳骤停常见原因分析 8 themortalityratepost cardiacarrest 3 44per10 000anesthetics ofthose0 10duetoAM 0 57duetoIP 0 76duetoSG 1 99duetoPC 麻醉期间心跳骤停常见原因分析 9 USteachinghospital 13yearsfromtheUniversityofPittsburghMedicalCenter UPMC betweenJanuary1 1989toDecember31 2001218274anesthesiacases including203382generalanesthesiacases 12282spinalanesthesiacases2610epiduralanesthesiacases 麻醉期间心跳骤停常见原因分析 10 intraoperativecardiacarrestfromallcauseswas1 05per10000anestheticsduetoanesthesiaof0 45per100000 60 8 diedintheoperatingroom 麻醉期间心跳骤停常见原因分析 11 麻醉期间心跳骤停常见原因分析 12 麻醉期间心跳骤停常见原因分析 13 Characteristicsofintraoperativecardiacarrest aremarkablepercentageofpatients 86 9 whohadintraoperativecardiacarrestwereclassifiedasASAPSIVorV SurvivalwassignificantlyimprovedinpatientswithASAPSI III 66 7 comparedwiththosewithASAPSIV V 35 thesurvivalratewaslowerinpatientsolderthan65years 20 comparedtopatientsyoungerthan64yearsold 53 5 Asystolewasthemostcommon 52 oninitialEKGrhythm andthosepatientsseemedlesslikelytosurviveafterresuscitationcomparedtootherrhythmssuchasPEAandVF 麻醉期间心跳骤停常见原因分析 14 Characteristicsofintraoperativecardiacarrest Therewasnodifferencebetweenmalesandfemalesinthesurvivalratetherewerenosignificantdifferencesinpatients survivalrateswithtrauma 50 oremergencysurgery 42 comparedwithnon trauma 36 orelectivesurgery 36 麻醉期间心跳骤停常见原因分析 15 麻醉期间心跳骤停常见原因分析 16 寻找6H 5T 对寻找可能导致心搏骤停的原因很有帮助 麻醉期间心跳骤停常见原因分析 17 6H 低血容量hypovolemia 低氧血症hypoxia 氢离子 酸中毒 hydrogenion acidosis 低 高钾血症hypo hyperkalemia 低血糖hypoglycemia 低体温hypothermia 麻醉期间心跳骤停常见原因分析