Family Presence during Cardiopulmonary Resuscitation

被引：237

作者：

Jabre, Patricia ^{[1
,3
,4
]}

Belpomme, Vanessa ^{[8
]}

Azoulay, Elie ^{[5
]}

Jacob, Line ^{[9
]}

Bertrand, Lionel ^{[10
]}

Lapostolle, Frederic ^{[1
]}

Tazarourte, Karim ^{[11
]}

Bouilleau, Guillem ^{[12
]}

Pinaud, Virginie ^{[13
]}

Broche, Claire ^{[6
]}

Normand, Domitille ^{[1
]}

Baubet, Thierry ^{[2
]}

Ricard-Hibon, Agnes ^{[8
]}

Istria, Jacques ^{[14
]}

Beltramini, Alexandra ^{[15
]}

Alheritiere, Armelle ^{[1
]}

Assez, Nathalie ^{[16
]}

Nace, Lionel ^{[17
]}

Vivien, Benoit ^{[4
]}

Turi, Laurent ^{[18
]}

Launay, Stephane ^{[19
]}

Desmaizieres, Michel ^{[1
]}

Borron, Stephen W. ^{[20
]}

Vicaut, Eric ^{[7
]}

Adnet, Frederic ^{[1
]}

机构：

[1] Hop Avicenne, AP HP, SAMU, F-93000 Bobigny, France

[2] Hop Avicenne, AP HP, Serv Psychiat, F-93000 Bobigny, France

[3] Univ Paris 05, INSERM, U970, Ctr Rech Cardiovasc Paris, Paris, France

[4] Hop Necker Enfants Malad, AP HP, SAMU Paris, Paris, France

[5] Hop St Louis, AP HP, Paris, France

[6] Hop Lariboisiere, AP HP, F-75475 Paris, France

[7] Hop Fernand Widal, AP HP, Unite Rech Clin, Paris, France

[8] Hop Beaujon, AP HP, Clichy, France

[9] Hop Henri Mondor, AP HP, F-94010 Creteil, France

[10] Hop Montauban, Montauban, France

[11] Hop Melun, Melun, France

[12] Hop Chateauroux, Chateauroux, France

[13] Hop Nantes, Nantes, France

[14] Hop Toulon, Toulon, France

[15] Hop Dreux, Dreux, France

[16] Hop Lille, Lille, France

[17] Hop Nancy, Nancy, France

[18] Hop Comminges Pyrennees, St Gaudens, France

[19] Hop Pontoise, Pontoise, France

[20] Texas Tech Univ, Hlth Sci Ctr, Dept Emergency Med, El Paso, TX USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2013年 / 368卷 / 11期

关键词：

AMERICAN-HEART-ASSOCIATION; WITNESSED RESUSCITATION; INVASIVE PROCEDURES; MEMBERS; GUIDELINES; HEALTH; BEREAVEMENT; DEPRESSION; SYMPTOMS; COUNCIL;

D O I：

10.1056/NEJMoa1203366

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. METHODS We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims. RESULTS In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P = 0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P = 0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims. CONCLUSIONS Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.)

引用

页码：1008 / 1018

页数：11

共 31 条

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