院外心脏骤停由异物气道梗阻引起：澳大利亚维多利亚州的一项基于人群的研究
Out‑of‑Hospital Cardiac Arrest from Foreign Body Airway Obstruction: A Population‑Based Study in Victoria, Australia.
文献信息
| PMID | 42735815 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Belinda Delardes |
| 作者单位 | Centre for Research and Evaluation, Ambulance Victoria, 375 Manningham Road, Doncaster, Victoria, Australia; Department of Paramedicine, Monash University, 47-49 Moorooduc Hwy, Frankston, Victoria, Australia. Electronic address: Belinda.delardes@ambulance.vic.gov.au. |
| 期刊 | Resuscitation |
| SCI 分区 | Q1 |
| IF | 6.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 异物气道梗阻（FBAO）是一种时间紧迫的急症，可迅速进展为心脏骤停。尽管具有重要的临床意义，但描述由FBAO引发的院外心脏骤停（OHCA）的当代流行病学数据仍然有限。
方法： 我们对澳大利亚维多利亚州（2020年7月1日至2024年6月30日）所有由紧急医疗服务（EMS）接诊并记录于维多利亚救护车心脏骤停登记处的OHCA病例进行了回顾性分析。纳入所有由FBAO引发的心脏骤停。我们提取数据以描述用于解除梗阻的干预措施的顺序、类型和有效性。
结果： 在29,684例OHCA中，223例（0.8%）由FBAO引起。中位年龄为77岁，大多数事件发生在私人住宅（56%）或住宿护理机构（30%）。16%的患者未接受任何旁观者干预。最常见的EMS干预措施是心肺复苏（n=171，84.2%），其次是使用Magill钳（n=119，58.6%）和吸引（n=111，54.7%）。Magill钳和气管插管是建立通气最有效的技术（使用时成功率均为73%），而喉罩气道装置虽经常使用（n=67，35%），但很少有效（7%）。165例（74.0%）患者成功移除FBAO；虽然107例（48.0%）实现自主循环恢复，但仅8例（3.6%）存活至出院。在65岁以上患者中（n=165），无存活者。
结论： 由FBAO引起的OHCA与极差的生存率相关，尤其是在65岁以上患者中。研究结果强调了及时旁观者干预的至关重要性，以及需要基于证据的EMS干预措施和无效性评估。
英文摘要
BACKGROUND: Foreign body airway obstruction (FBAO) is a time-critical emergency that can rapidly progress to cardiac arrest. Despite its clinical significance, contemporary epidemiological data describing out-of-hospital cardiac arrest (OHCA) precipitated by FBAO remain limited.
METHODS: We conducted a retrospective analysis of all emergency medical service (EMS)-attended OHCA cases in Victoria, Australia (1 July 2020-30 June 2024) recorded in the Victorian Ambulance Cardiac Arrest Registry. All arrests precipitated by FBAO were included. We extracted data to characterise the sequence, type, and effectiveness of interventions used to relieve obstruction.
RESULTS: Of 29,684 OHCAs, 223 (0.8%) were due to FBAO. Median age was 77 years, and most events occurred in private residences (56%) or residential care homes (30%). Sixteen percent of patients received no bystander intervention. The most common EMS interventions were CPR (n=171, 84.2%) followed by use of Magill's forceps (n=119, 58.6%) and suction (n=111, 54.7%). Magill's forceps and intubation were the most effective techniques for establishing ventilation (each with 73% success when used), whereas laryngeal mask airway devices were frequently used (n=67, 35%) but rarely effective (7%). FBAO removal was achieved in 165 (74.0) patients; whilst 107 (48.0%) achieved return of spontaneous circulation, only 8 (3.6%) survived to hospital discharge. Among patients aged over 65 years (n=165), there were no survivors.
CONCLUSION: OHCA due to FBAO is associated with extremely poor survival, particularly in patients aged over 65 years. The findings emphasise the critical importance of prompt bystander intervention and the need for evidence-informed EMS interventions and assessment of futility.