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如何定義 ROSC?
2008/02/27 04:54:28瀏覽16290|回應0|推薦2
只要>30秒的ROSC就可以算『any ROSC』
 > 20 min 的 ROSC,就是『sustained ROSC』或稱『survived event』。

Return of Spontaneous Circulation
Signs of the return of spontaneous circulation (ROSC) include breathing (more than an occasional gasp), coughing, or movement. For healthcare personnel, signs of ROSC also may include evidence of a palpable pulse or a measurable blood pressure. For the purposes of the Utstein registry template, "successful resuscitation" or ROSC is defined for all rhythms as the restoration of a spontaneous perfusing rhythm that results in more than an occasional gasp, fleeting palpated pulse, or arterial waveform. Assisted circulation (eg, extracorporeal support such as extracorporeal membrane oxygenation or a biventricular assist device) should not be considered ROSC until "patient-generated" (ie, spontaneous) circulation is established. Previous reports that focused on outcomes from ventricular fibrillation have variably defined "successful defibrillation" as the termination of fibrillation to any rhythm (including asystole) and the termination of fibrillation to an organized electrical rhythm at 5 seconds after defibrillation (including pulseless electrical activity [PEA]). Neither of these definitions of successful defibrillation would qualify as ROSC unless accompanied by evidence of restored circulation. By consensus, the phrase "any ROSC" is intended to represent a brief (approximately >30 seconds) restoration of spontaneous circulation that provides evidence of more than an occasional gasp, occasional fleeting palpable pulse, or arterial waveform. The time at which ROSC is achieved is a core data element.

Survived Event
"Survived event" for the out-of-hospital setting means sustained ROSC with spontaneous circulation until admission and transfer of care to the medical staff at the receiving hospital. For the in-hospital setting, survived event means sustained ROSC for >20 minutes (or the return of circulation if extracorporeal circulatory support is applied).

Survival to Hospital Discharge
Survival to hospital discharge is the point at which the patient is discharged from the hospital's acute care unit regardless of neurological status, outcome, or destination. Ideally, this should indicate survival to discharge from acute hospital care, including a possible rehabilitation period in a local hospital before long-term care, home care, or death.

Sustained ROSC
Sustained ROSC is deemed to have occurred when chest compressions are not required for 20 consecutive minutes and signs of circulation persist (or sustained ROSC if extracorporeal circulatory support is applied). Thus, after resuscitation from in-hospital cardiac arrest, sustained ROSC and survived event have the same definition.


詳讀:
http://circ.ahajournals.org/cgi/content/full/110/21/3385
( 知識學習隨堂筆記 )

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