{"id":24405,"date":"2023-08-21T04:38:00","date_gmt":"2023-08-20T20:38:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24405"},"modified":"2023-08-21T05:39:23","modified_gmt":"2023-08-20T21:39:23","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%83%ba%e7%a2%98%e9%85%ae%e4%b8%8e%e5%88%a9%e5%a4%9a%e5%8d%a1%e5%9b%a0%e6%b2%bb%e7%96%97%e9%99%a2%e5%86%85%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24405","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u80fa\u7898\u916e\u4e0e\u5229\u591a\u5361\u56e0\u6cbb\u7597\u9662\u5185\u5fc3\u8df3\u9aa4\u505c\u7684\u6bd4\u8f83"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSUE 5<\/a>, P1109-1119, MAY 2023Download Full Issue<\/p>\n\n\n\n

Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest<\/h1>\n\n\n\n

Deborah Wagner, S.L. Kronick, H. Nawer, et al<\/h3>\n\n\n\n

Chest 2023; 153: 1109-1119 Published:November 01, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2022.10.024<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

American Heart Association Advanced Cardiac Life Support (ACLS) guidelines support the use of either amiodarone or lidocaine for cardiac arrest caused by ventricular tachycardia or ventricular fibrillation (VT\/VF) based on studies of out-of-hospital cardiac arrest. Studies comparing amiodarone and lidocaine in adult populations with in-hospital VT\/VF arrest are lacking.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Does treatment with amiodarone vs lidocaine therapy have differential associations with outcomes among adult patients with in-hospital cardiac arrest from VT\/VF?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

This retrospective cohort study of adult patients receiving amiodarone or lidocaine for VT\/VF in-hospital cardiac arrest refractory to CPR and defibrillation between January 1, 2000, and December 31, 2014, was conducted within American Heart Association Get With the Guidelines-Resuscitation (GWTG-R) participating hospitals. The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes were 24 h survival, survival to hospital discharge, and favorable neurologic outcome.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Among 14,630 patients with in-hospital VT\/VF arrest, 68.7%\u00a0(n\u00a0= 10,058) were treated with amiodarone and 31.3%\u00a0(n\u00a0= 4,572) with lidocaine. When all covariates were statistically controlled, compared with amiodarone, lidocaine was associated with statistically significantly higher odds of the following: (1) ROSC (adjusted OR [AOR], 1.15,\u00a0P<\/em>\u00a0= .01; average marginal effect [AME], 2.3; 95%\u00a0CI, 0.5 to 4.2); (2) 24\u00a0h survival (AOR, 1.16;\u00a0P<\/em>\u00a0= 004; AME, 3.0; 95%\u00a0CI, 0.9 to 5.1); (3) survival to discharge (AOR, 1.19;\u00a0P<\/em>\u00a0< .001; AME, 3.3; 95%\u00a0CI, 1.5 to 5.2); and (4) favorable neurologic outcome at hospital discharge (AOR, 1.18;\u00a0P<\/em>\u00a0< .001; AME, 3.1; 95%\u00a0CI, 1.3 to 4.9). Results using propensity score methods were similar to those from multivariable logistic regression analyses.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Compared with amiodarone, lidocaine therapy among adult patients with in-hospital cardiac arrest from VT\/VF was associated with statistically significantly higher rates of ROSC, 24\u00a0h survival, survival to hospital discharge, and favorable neurologic outcome.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSU […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24405"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24405"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24405\/revisions"}],"predecessor-version":[{"id":24406,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24405\/revisions\/24406"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24405"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24405"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}