中国成人心搏骤停后综合征中西医结合诊治专家共识（2023）

中华危重病急救医学2023年10月第35卷第10期Chin Crit Care Med,0 ctober2023.Vd.35.Na.101009··专家共识·中国成人心搏骤停后综合征中西医结合诊治专家共识（2023)中国中西医结合学会急救医学专业委员会国家卫健委危重病急救医学重，点实验室执笔人：李海林李银平陈明显傳睿丁邦晗通信作者：李海林，浙江省立同德医院急诊科，杭州310012，Email:newnew(0410@qq.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，中西医结合诊治是改善PCAS预后的重要手段。为指导和规范我国临床医师、护理人员、相关教学和研究人员对PCAS中西医结合诊治的认识和使用，中国中西医结合学会急救医学专业委员会成立专家组，经临床调研确定中西医结合诊治PCAS的14个临床问题，对每个临床问题按照ICO原则制定检索策略，检索CNKI、万方、维普、SinoMed、PubMed、.Embase、Cochrane Library相关的中英文文献，借鉴推荐分级的评估、制订与评价(GRADE)指南意见形成证据等级和推荐级别。当文献证据不足时，经专家讨论形成推荐建议及推荐级别，结合可推广性、适宜性和资源利用等方面，围绕PCS患者早期循环、呼吸支持及可逆病因解除，中期神经保护、改善凝血、防治感染、肾与胃肠保护及控制血糖，后期康复等3期14个方面形成28条推荐意见，为现阶段PCAS中西医结合诊治提供参考和依据。【关键词】心搏骤停后综合征；心搏骤停；成人；中西医结合诊治；共识实践指南注册：国际实践指南注册与透明化平台，PREPARE-2023CN421D0I:10.3760/cma.j.cn121430-20230806-00582Expert consensus for diagnosis and treatment of post-cardiac arrest syndrome in adults by combiningtraditional Chinese and Western medicine in China(2023)Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine,Key Laboratory of Critical Illness Emergency Medicine of the National Health Commission;Li Hailin,Li Yinping,Chen Mingxian,Fu Rui,Ding BanghanCorresponding author:Li Hailin,Department of Emergency,Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang,China,Email:newnew0410@qq.com[Abstract]Reperfusion injury occurs after return of spontaneous circulation (ROSC)in patients with cardiacarrest (CA),which leads to multiple organ dysfunction,called post-cardiac arrest syndrome (PCAS).PCAS is closelyrelated to the prognosis of CA patients,and is an independent risk factor of survival.Integrated traditional Chinese andWestemn medicine diagnosis and treatment is critical for improving prognosis of PCAS.In order to guide and standardizeintegrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians,nurses andresearch personnel in China,the Emergency Medicine Professional Committee of the Chinese Society of IntegratedChinese and Wester Medicine has established an expert group to determine 14 clinical issues related to the diagnosis andtreatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey.The working groupformulates a search strategy for each clinical issue according to the PICO principle.Chinese and English literature weresearched from CNKI,Wanfang,VIP,SinoMed,PubMed,Embase,and Cochrane Library.The grade of recommendationsassessment,development and evaluation (GRADE)were used to form the level of evidence and recommendation.Whenthe literature evidence was insufficient,the recommendations and level of recommendation were formed after expertdiscussion.Combined with the aspects of generalizability,suitability,and resource utilization,the expert consensusdeveloped 28 recommendations around the 14 aspects of three stages of PCAS,including early circulation,respiratorysupport and reversible cause relief,mid-term neuroprotect