RECHERCHES SCIENTIFIQUES

EVALUATION DE LA PRISE EN CHARGE DE L’ARRET CARDIAQUE AUX URGENCES DU CHU HASSAN II DE FES (A propos de 225 cas)

Référence925
Année2016
TypeThèse
Lien document
AuteurEl mekkaoui A
DisciplineRéanimation Polyvalente 2
EncadrantBoukatta B

Cardiac arrest (CA) is the removal of any effective circulatory activity, leading to the discontinuation of the infusion of vital organs. Tissue anoxia induced causes in minutes cell damage, including brain, rapidly irreversible in the absence of treatment and resulting in sudden death. It may also be defined by: A cessation of cardiac mechanical activity, confirmed by the absence of a detectable pulse. The lack of response. Apnea or agonal respirations. Generally two types of cardiac arrest there are: § a shockable cardiac arrest: ventricular tachycardia (VT) or ventricular fibrillation (VF) § a non-shockable cardiac arrest: asystole and electromechanical dissociation. This is a prospective study over 6 months for patients hospitalized shock treatment room of University Hospital adult emergency Hassan II of Fez who experienced a cardiac arrest. Two hundred and twenty five patients were included in the study whose average age is 54 years (17 years -90 years), with a sex ratio M / F = 1.34, whose intake patterns to the shock treatment room are dominated by cardiac symptoms (21.3%), neurological (19%), respiratory (15%), and accidents of public roads (14%). The initial rate is dominated by asystole (84.8%). In our study the average ECM is 110 compressions / min, 13.8% of patients are defibrillated and 60% of patients are intubated. The adrenaline is still used as the main drug by IV bolus of 1 mg / 3min. The average duration of resuscitation is 28 minutes with a recovery rate of 11.8%, 2 patients are alive. The various causes of the CA in our study are dominated by: cardiac origin: (IDM: 10.6% OAP: 7% EP: 3.5%), followed by septic shock (15.5 %), intracranial hypertension syndrome (12.5%) and severe polytrauma (10.6%). Cardio-circulatory arrest is a major problem of public health, which compels us to codified its management within our establishment based on studies, latest recommendations and implementation of good practices.