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1、关于麻醉期间心跳骤停常见原因分析第一张,PPT共十九页,创作于2022年6月第二张,PPT共十九页,创作于2022年6月第三张,PPT共十九页,创作于2022年6月JapanSocietyofAnesthesiologists(JSA) Certified Training Hospitals (CTH) A total number of 793,840 anesthetics Total incidence of cardiac arrest under anesthesia/surgery was 6.53 per 10,000 anesthetics 第四张,PPT共十九页,创作于20

2、22年6月principal causes of total cardiac arrest casesPC 42.9%,IP 22.0% SG 21.4% AM 12.0% (AM:incidence rate of 0.78 per 10,000)(PC) preoperative complications(IP) intraoperative pathological events(SG) surgery(AM) anesthetic management第五张,PPT共十九页,创作于2022年6月In 52 more detailed classification of princip

3、al causes of cardiac arrest 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%), the third cause intraoperative myocardial infarction/coronary ischemia/coronary spasm (9.5%) 第六张

4、,PPT共十九页,创作于2022年6月Prognoses of cardiac arrestdeclined due to PC: 71.1% of cardiac arrests died in theoperatingroomor within 7 days after surgery and only 19.8% survived without sequelae. The best prognoses due to AM: 69.4% survived without sequelae and 12.9% died. 第七张,PPT共十九页,创作于2022年6月themortality

5、rate post-cardiac arrest3.44 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. 第八张,PPT共十九页,创作于2022年6月 US teaching hospital 13 years from the University of Pittsburgh Medical Center (UPMC) between January 1, 1989 to December 31, 2001 218 274 anesthesia c

6、ases, including 203 382 general anesthesia cases, 12 282 spinal anesthesia cases 2610 epidural anesthesia cases 第九张,PPT共十九页,创作于2022年6月intraoperative cardiac arrest from all causes was 1.05 per 10 000 anestheticsdue to anesthesia of 0.45 per 100 000 (60.8%) died in the operating room 第十张,PPT共十九页,创作于2

7、022年6月第十一张,PPT共十九页,创作于2022年6月第十二张,PPT共十九页,创作于2022年6月Characteristics of intraoperative cardiac arrest 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 IIII (66.7%) compared

8、with those with ASA PS IVV (35%). 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

9、 rhythms such as PEA and VF; 第十三张,PPT共十九页,创作于2022年6月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%) 第十四张,PPT共十九页,创作于2022年6月第十五张,PPT共十九页,创作于2022年6月寻找6H/5T,对寻找可能导致心搏骤停的原因很有帮助第十六张,PPT共十九页,创作于2022年6月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第十七张,PPT共十九页,创作于2022年6月5T中毒 to

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