心脏骤停幸存者和他们的亲人之间的健康联系

Lea en español

林恩·怀尔斯和肯特·怀尔斯都认为她死后又复活的那一天是个奇迹.

The couple's experience then and in the years since also illustrates how recovery from a cardiac arrest can both unite and disrupt families who go through it together.

62岁的肯特仍然需要暂停，当他 retells 2020年7月31日发生了什么. 他和林恩是怎么去买杂货的. 他是怎么把第一批行李带进奥尔巴尼的, Oregon, 回家后，转过身来帮忙做剩下的事. 以及他接下来看到的.

“就在你走进前门的时候，林恩就在地毯上死了. 她心脏骤停."

他的声音停顿了，他吸了一口气. “现在谈论这件事还是很困难."

他回忆起她的脸和嘴是蓝色的，她的眼睛是不动的. He remembers calling 911 and beginning CPR – and the "horrifying" choking sound she made with what could have been her dying breath. 他还记得那个帮助过他的邻居, 带着除颤器来的医护人员, 他们使她苏醒的喜讯.

林恩完全不记得这些.

她还记得从商店回家的路上, 带她去医院的救护车上闪烁的灯光, and waking up that day to the news she'd had a heart attack that led to a cardiac arrest. 得知她丈夫救了她.

“在整个过程中，他非常清醒，非常警觉，非常英勇，”她说. “我死了."

Those linked-but-separate experiences distinguish cardiac arrest from other life-threatening illnesses, said Dr. 萨钦。, director of the neurocardiac program at NewYork-Presbyterian Hospital/Columbia University Medical Center in New York.

Cardiac arrest is an electrical malfunction that causes the heart to stop beating suddenly. It can be caused by a heart attack, which is when blood flow to the heart muscle is blocked. Because most cardiac arrests occur at home, family members often are the initial rescuers.

对他们来说，目睹心脏骤停是改变人生的时刻. “你当时正在拨打911，”阿加瓦尔说. “你现在提供心肺复苏术. You are worried about your kids sleeping in the other room and what will happen if they walk in and see their loved one being resuscitated."

Dr. Cynthia M. Dougherty, the Charles and Gerda Spence Endowed Professor in Nursing at the University of Washington School of Nursing, 说"看着你爱的人死去，还要救活他们, 或者看着别人抢救他们, is 一个非常痛苦的线上娱乐电子游戏网站 为照顾者."

这可能只是创伤的开始, 多尔蒂说, who also is a professor in the cardiology division of the university's medical school and a nurse practitioner at the Seattle VA Medical Center. She began doing research into cardiac arrest survivors and their families in the 1990s and co-wrote a 2020 美国心脏协会 科学声明 关于心脏骤停幸存者.

"The scariest part during hospitalization 为照顾者 and spouses is whether the patient is going to wake up at all," she said. 在全国范围内，成年人中只有9人.据统计，接受急救人员治疗的院外心脏骤停患者中有3%存活下来 AHA statistics. 但即使那些幸存下来的人也可能会昏迷几天.

当亲人等待时, 多尔蒂说, 他们不仅要怀疑这个人是否会活下去, 但如果他们这样做，他们是否会神经残疾.

“最初的日子真的非常非常艰难，”她说.

而心脏骤停的人可能什么都不记得.

"Sometimes, 病人必须在数周内反复被提醒, 甚至在他们回家后的几个月, 关于到底发生了什么,多尔蒂说. “因为他们唯一的参考就是别人给他们讲的故事."

许多幸存者患上了创伤后应激障碍, 这可能会导致睡眠中断和其他心血管健康问题. Agarwal's 2019 study published in Critical Care Medicine showed that survivors who develop PTSD symptoms have a significantly higher risk of further cardiovascular events or death within a year compared to survivors without PTSD symptoms.

Family members also can develop post-traumatic stress that "is equal or higher than what the survivors have," Agarwal said. 照顾者或共同幸存者， 报告问题 比如抑郁、睡眠不佳以及随后数月或数年的孤立感.

但他说，压力的根源各不相同. 而其他幸存者正在处理他们所看到的震惊, 幸存者正在重症监护室度过他们的时光, trying to process how their bodies betrayed them and looking for signs it could happen again.

多尔蒂说，最终，幸存者的焦点变成了试图治愈. “他们希望向前迈进."

但如果他们的伴侣还在处理他们所看到的，那就会导致分歧.

"Oftentimes, what happens is that the patient doesn't really realize the serious impact of their cardiac arrest on their partner,多尔蒂说, while the partner may be afraid to say how scared they are and how awful the experience was because they don't want to frighten them.

不同的观点可能会导致影响到每个人的问题. Co-survivors can become overprotective, which limits their ability to return to work or socialize. That, Agarwal said, 会导致“恶性循环”吗, 不良的心理健康导致不良的身体恢复, 然后整个家庭的生活质量就会下降."

相互关联的因素, Agarwal said, 这意味着医护人员需要治疗的不仅仅是幸存者, 还有他们的伴侣.

“除非你一起治愈他们，否则是行不通的，”他说. 其中之一将继续影响经济复苏的轨迹."

Families have told researchers that what helps them most is clear explanations of what happened and what is likely to happen next. “人们非常渴望获得信息，因为医疗团队, 因为线上电子游戏飞禽走兽不够, 沟通不够, 当他们这么做的时候, 里面全是医学术语,阿加瓦尔说, 谁正在进行有关呈现此类信息的最佳方式的持续研究.

Dougherty has done research involving patients with implantable cardioverter defibrillators, or ICDs, 通过电击来防止心脏骤停. Her work, which involved a program that included education and access to a nurse who could answer questions, 发现当病人和伴侣都能接触到, 两者都比单独接受治疗的患者获益更多.

The AHA statement that Dougherty helped write noted a lack of specific research into many things that could help survivors and their families. But Agarwal said that everyone involved – including children – needs to be open and communicative and look for ways to heal together.

“如果他们试图独立行事，”他说，“我认为这是行不通的."

多尔蒂说 that partners and patients have separate paths toward healing and that partners definitely deserve help, 但医疗保健系统没有办法为他们提供实质性的支持."

肯特·怀尔斯和林恩·怀尔斯一致认为，信息是他们康复的重要组成部分.

林恩只在医院住了三天, 但在她离开之前, 肯特已经在收集有关心脏健康饮食的事实. 这对夫妇收到并查看了林恩治疗的完整记录. 肯特甚至拿到了他报警电话的录音.

有一段线上电子游戏飞禽走兽，他们从视频支持小组中受益. 肯特还接受了一位临床社工的咨询. 林恩继续享受心脏康复. “这是一个快乐的地方，”她说.

These days, 肯特提前退休了, while Lynn, now 64, works full time as a medical office receptionist in a cardiology clinic at Good Samaritan Regional Medical Center – working for the same doctors who treated her. 当被问及这个问题时，两人分享了他们的故事，并敦促人们学习心肺复苏术. 他们一起笑着纠正彼此共同经历的细节, 就像一对结婚20年的夫妻应该做的那样. 他们一起散步.

但他们的道路总是略有不同.

Each night, when he sits at the dining room table to meditate, he points to the spot where she fell. 林恩在脱下凉鞋的时候就学会了这一点, she shouldn't leave them crossed – because that's how they were left the day she collapsed, 看到这些，他感到不安.

肯特说:“当她离开房间时，我不会完全信任她。. 如果林恩应该在家，他会担心不能马上见到她. “她在楼上吗?? 她又死了吗?"当她睡着时，他会翻过身来检查她"确保她还活着."

当肯特在她切蔬菜的时候在她身边徘徊时，林恩不得不告诉他离她远点. (他担心她在服用血液稀释剂时会割伤自己.)但她也会留下安慰的便条，这样他就知道她出门时在哪里.

His hypervigilance is a way of calming his nerves, he said, but things have gotten better over time. “我想，在某种程度上，我每天都在应对它. 但我也对她心存感激."

他经历了很多. “我感到无比感激，”他说. “比我以前经历过的更多."