麻醉期间心跳骤停常见原因分析ppt精选课件

.,术中心跳骤停相关性因素分析,.,.,.,JapanSocietyofAnesthesiologists(JSA)CertifiedTrainingHospitals(CTH),Atotalnumberof793,840anestheticsTotalincidenceofcardiacarrestunderanesthesia/surgerywas6.53per10,000anesthetics,.,principalcausesoftotalcardiacarrestcases,PC42.9%,IP22.0%SG21.4%AM12.0%(AM:incidencerateof0.78per10,000),(PC)preoperativecomplications(IP)intraoperativepathologicalevents(SG)surgery(AM)anestheticmanagement,.,In52moredetailedclassificationofprincipalcausesofcardiacarrest,themostfrequentcausepreoperativehemorrhagicshock,20.3%ofallcardiacarrests.Thesecondcausemassivehemorrhageand/orhypovolemiaduetosurgicalprocedures(13.1%),thethirdcauseintraoperativemyocardialinfarction/coronaryischemia/coronaryspasm(9.5%),.,Prognosesofcardiacarrest,declinedduetoPC:71.1%ofcardiacarrestsdiedintheoperatingroomorwithin7daysaftersurgeryandonly19.8%survivedwithoutsequelae.ThebestprognosesduetoAM:69.4%survivedwithoutsequelaeand12.9%died.,.,themortalityratepost-cardiacarrest,3.44per10,000anesthetics,ofthose0.10duetoAM,0.57duetoIP,0.76duetoSG,1.99duetoPC.,.,USteachinghospital,13yearsfromtheUniversityofPittsburghMedicalCenter(UPMC)betweenJanuary1,1989toDecember31,2001218274anesthesiacases,including203382generalanesthesiacases,12282spinalanesthesiacases2610epiduralanesthesiacases,.,intraoperativecardiacarrestfromallcauseswas1.05per10000anestheticsduetoanesthesiaof0.45per100000(60.8%)diedintheoperatingroom,.,.,.,Characteristicsofintraoperativecardiacarrest,aremarkablepercentageofpatients(86.9%)whohadintraoperativecardiacarrestwereclassifiedasASAPSIVorV.SurvivalwassignificantlyimprovedinpatientswithASAPSIIII(66.7%)comparedwiththosewithASAPSIVV(35%).thesurvivalratewaslowerinpatientsolderthan65years(20%)comparedtopatientsyoungerthan64yearsold(53.5%).Asystolewasthemostcommon(52%)oninitialEKGrhythm,andthosepatientsseemedlesslikelytosurviveafterresuscitationcomparedtootherrhythmssuchasPEAandVF;,.,Characteristicsofintraoperativecardiacarrest,Therewasnodifferencebetweenmalesandfemalesinthesurvivalratetherewerenosignificantdifferencesinpatientssurvivalrateswithtrauma(50%)oremergencysurgery(42%)comparedwithnon-trauma(36%)orelectivesurgery(36%),.,.,寻找6H/5T，对寻找可能导致心搏骤停的原因很有帮助,.,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hypoth