Abstract | Uvod. Kardiopulmonalna reanimacija (KPR) ima ključnu ulogu u slučaju iznenadnog
srčanog zastoja. Rano prepoznavanje aresta te brza i pravovremena kardiopulmonalna
reanimacija značajno utječu na ishod osobe koja je doživjela iznenadni srčani zastoj posebice
u izvanbolničkom okruženju. Ovaj diplomski rad analizira utjecaj laičke reanimacije na ishod
reanimacija posebice na stopu preživljavanja unesrećenih kod kojih je laička reanimacija bila
provođena za razliku od onih kod kojih to nije bio slučaj.
Ciljevi istraživanja. Cilj ovog diplomskog rada bio je istraživanje utjecaja laičke
reanimacije na sam ishod reanimacija, analiziranje rezultata kardiopulmonalne reanimacije s
obzirom na uspostavu spontane cirkulacije, provjera dostupnosti automatskih vanjskih
defibrilatora te dostupnosti tečajeva o osnovnim mjerama za održavanje života za laike.
Metode istraživanja. Za potrebe ovog istraživačkog rada korišteni su podaci Utstein
obrasca za provedbu reanimacije u Varaždinskoj županiji u periodu od 2022. - 2023. godine.
Sve statističke analize su provedene korištenjem MedCalc 20.305 (MedCalc Software Ltd,
Ostend, Belgija). Statistički značajnima su smatrane P vrijednosti manje od 0.05.
Rezultati. U istraživanju smo koristili 442 Utstein obrasca, odnosno 442 reanimacije
od toga 144 žena (33%) i 285 muškarac (65%), a za 13 bolesnika su podaci nepoznati..
Najviše aresta imalo je medicinski uzrok (365 ispitanika, 82.5%), dok je ostalih uzroka bilo
značajnije manje. Nije bilo statistički značajne razlike u uzrocima aresta između muškaraca i
žena, P=0.261. Laička reanimacija se provodila u 219 (50%) slučajeva. Upotreba AVD-a od
strane laika je bila upotrebljena u 5 (2%) slučajeva. Do dolaska u bolnicu ROSC je imalo
ukupno 49 (11%) bolesnika te je uspostava ROSC-a bila povezana s početnim ritmom,
P<0.001 i značajnije češća u reanimacijama kod kojih je prvotno bila prisutna laička
reanimacija, P<0.001. Također, uspostava ROSC-a je bila učestalija u slučajevima s kraćim
vremenom od poziva do dolaska HMS, P<0.001
Zaključak. Zaključci ovog diplomskog rada ističu značaj laičke reanimacije kao
jednog od najbitnijih faktora u lancu preživljavanja osoba koje su doživjele iznenadni srčani
zastoj. Edukacija laika o kardiopulmonalnoj reanimaciji, o funkciji i svrsi automatskih
vanjskih defibrilatora i stalno podizanje svijesti laika o važnosti brzog i adekvatnog reagiranja
kod iznenadnog srčanog zastoja ključni su za pozitivne ishode kardiopulmonalne reanimacije. |
Abstract (english) | Introduction. Cardiopulmonary resuscitation (CPR) plays a key role in the event of
sudden cardiac arrest. Early recognition of arrest and rapid and timely cardiopulmonary
resuscitation significantly affect the outcome of a person who has experienced sudden cardiac
arrest, especially in an outpatient setting. This thesis analyzes the influence of lay
resuscitation on the outcome of resuscitation, especially on the survival rate of victims in
whom lay resuscitation was carried out, unlike those in whom it was not the case.
Research objectives. The aim of this thesis was to investigate the influence of lay
resuscitation on the outcome of resuscitation itself, to analyze the results of cardiopulmonary
resuscitation with regard to the establishment of spontaneous circulation, to check the
availability of automatic external defibrillators and the availability of courses on basic life
support measures for lay people.
Research methods. For the purposes of this research work, the data of the Utstein
form for the implementation of resuscitation in Varaždin County in the period from 2022 to
2023 were used. All statistical analyses were performed using MedCalc 20.305 (MedCalc
Software Ltd, Ostend, Belgium). P values of less than 0.05 were considered statistically
significant.
Results. In the research, we used 442 Utstein forms, i.e. 442 resuscitations, of which
144 were women (33%) and 285 men (65%), and the data are unknown for 13 patients.. The
most arrests were of a medical cause (365 subjects, 82.5%), while other causes were
significantly less. There was no statistically significant difference in the causes of arrest
between males from females, P=0.261. Lay resuscitation was performed in 219 (50%) cases.
Lay people's use of AVD was used in 5 (2%) cases. Until arriving at the hospital, ROSC had a
total of 49 (11%) patients, and the establishment of ROSC was associated with the initial
rhythm, P<0.001 and more significantly more common in resuscitations in which lay
resuscitation was originally present, P<0.001. Also, the establishment of ROSC was more
frequent in cases with shorter call times until the arrival of HMS, P<0.001
Conclusion. The conclusions of this thesis highlight the importance of lay
resuscitation as one of the most important factors in the chain of survival of people who have
experienced sudden cardiac arrest. Education of lay people on cardiopulmonary resuscitation,
on the function and purpose of automatic external defibrillators and constant raising of lay people's awareness of the importance of rapid and adequate response in case of sudden
cardiac arrest are key to positive outcomes of cardiopulmonary resuscitation |