中国成人心搏骤停后综合征器械支持治疗临床实践指南

中华危重病急救医学2022年8月第34卷第8期Chin Crit Care Med,August2022,Val.34.No.8·789··专家共识·中国成人心搏骤停后综合征器械支持治疗临床实践指南中国成人心搏骤停后综合征器械支持治疗临床实践指南研究项目组中华医学会急诊医学分会复苏学组中华医学会急诊医学分会胸痛学组中华医学会急诊医学分会心脑血管病学组山东省医学会心肺复苏与体外生命支持多学科联合委员会通信作者：陈玉国，Email:chen919085@sdu.edu.cn;徐峰，Email:xufengsdu@l26.com;于学忠，Email:yxzpumch@163.com;张海涛，Email:boy8672@126.com【摘要】心搏骤停(CA)患者自主循环恢复(ROSC)后发生再灌注损伤，导致机体出现多器官功能障碍，称为心搏骤停后综合征(PCAS)。PCAS与CA患者预后密切相关，是影响复苏患者存活率的独立危险因素，针对PCAS患者的器械支持治疗是改善其预后的重要手段。为指导和规范我国临床医师、护理人员及相关教学和研究人员对PCAS器被支持治疗的认识和使用，在世界卫生组织(WHO)指南制定手册的指导下，以推荐意见的分级、制订及评价(GRADE)系统为工具制订了首部PCAS器械支持治疗临床实践指南，指南围绕PCAS患者神经系统保护、循环系统治疗、呼吸系统支持及肾脏替代治疗等4个方面7种支持器械形成16条推荐意见：为现阶段PCAS临床诊疗提供参考和依据。【关键词】心搏骤停后综合征；心搏骤停；成人；器械支持治疗；指南基金项目：国家科技基础资源调查专项(2018FY100600,2018FY100602):国家自然科学基金重点项目(82030059)：国家重点研发计划(2020YFC1512700):山东省重点研发计划(2021ZLGX02):泰山学者攀登计划专家建设工程专项经费(tsp20181220);山东大学临床研究中心经费支持(2020 SDUCRCA006,2020 SDUCR CB003);山东大学青年交叉科学创新群体经费(2020QNQT004)D0I:10.3760/cma.j.cn121430-20220802-00709Clinical practice guidelines for device supportive care in adults with post cardiac arrest syndrome in ChinaChinese Clinical Practice Guidelines for Device Support Treatment in Adults with Post-Cardiac Arrest SyndromeWorking Group,Resuscitation Group of Emergency Medicine Branch of Chinese Medical Association,Chest Pain Groupof Emergency Medicine Branch of Chinese Medical Association,Cardio-cerebrovascular Disease Group of EmergencyMedicine Branch of Chinese Medical Association,Joint Multidisciplinary Committee of Cardiopulmonary Resuscitationand Extracorporeal Life Support of Shandong Provincial Medical AssociationCorresponding author:Chen Yuguo,Email chen919085@sdu.edu.cn:Xu Feng,Email:xufengsdu@126.com;Yu Xuezhong,Email:yx-pumch@163.com;Zhang Haitao,Email boy8672@126.com[Abstract Post cardiac arrest syndrome (PCAS)refers to the multiple organ dysfunction or failure after return ofspontaneous circulation (ROSC)in cardiac arrest(CA)patients.PCAS is closely related to the prognosis of CA patients,and is an independent risk factor of survival.Device supportive care is critical for improving prognosis of PCAS.In orderto guide and standardize device supportive care in PCAS among clinicians,nurses and research personnel in China,theworking group drafted the first clinical practice guidelines for device supportive care in adults with PCAS according toWorld Health Organization (WHO)guideline development manual,with the Grading of Recommendations Assessment,Development and Evaluation (GRADE)system.The guidelines developed sixteen recommendations on seven typesof devices in four aspects including neuroprotection,circulatory treatment,respiratory support and renal replacementtherapy,providing references for clinical management of PCAS.[Key words]Post cardiac arrest syndrome;Cardiac arrest:Adult:Device supportive care;GuidelineFund program:National S&T Fundamental Resources Investigation Project of China (2018FY100600,2018FY100602);State Key Program of the National Natural Science Foundation of China (82030059);National KeyR&D Program of C