The Significance Of Early Oxygen Uptake Rate Monitoring In Cardiopulmonary Resuscitation

Obiective: To investigate the correlation of the early oxygen uptake rate with theblood lactate clearance and the cardiac output in cardiopulmonary resuscitation afterspontaneous circulation restoration, and analyze its relationship with the prognosis ofthe patients.Methods: Select14cases of cardiac arrest patients during the period of October2012to January2014in emergency department of our hospital, all of them werereturned of spontaneous circulation through actively rescue, and survived more than6hours. There were8males and6females. According to the different prognosis of thepatients after ROSC3d were divided into death group (9cases) and survival group (5cases). Actively treating the primary disease during in the life-saving treatment for thepatients. Record the gender, age, weight, heart rate, blood pressure, mean arterialpressure, pulse oxygen saturation, blood and urine routine, liver and kidney functionsfor all of the cases. Puncture the internal jugular or subclavian deep venous, and inlyingthe catheter for all of the patients. Specimens were obtained from0h (immediate),6h,12h,24h and72h after cardiopulmonary resuscitation spontaneous circulation recovery,determine the arterial blood lactic acid value and arterial oxygen saturation, thencalculate the lactate clearance rate; draw blood from the deep venous catheter, andacquired the value of the central venous blood oxygen saturation from the point-of-careblood gas analyzer, and calculate the oxygen uptake rate of each time; at the same time,dynamic monitoring the cardiac output of all cases with the application of thoracicimpedance method for noninvasive hemodynamic monitoring instrument. For all of the patients, take its acute physiology score, age, and chronic health evaluation within24hfor APACHE Ⅱ score and record their survival time. Using statistical methods tocompare the differences of the relevant indicators in each group, and judging therelationship with these indicators and the prognosis of patients. Compared the twosample mean with t test, and using Spearman correlation to analyze the correlationbetween APACHEII score, oxygen uptake rate, lactate clearance and cardiac output;with P <0.05said the difference was statistically significant.Results: The oxygen uptake rate, lactate clearance rate and cardiac output atdifferent time of the death group is lower than the survival group (all P <0.05), but theAPACHE Ⅱ score of the death group is higher than the survival group (t=3.308, P<0.05), the difference is statistically significant. The6h of oxygen uptake rate ispositively correlated with lactate clearance rate(r=0.947, P<0.05) and cardiac output(r=0.936, P<0.05). The6h of oxygen uptake rate, lactate clearance rate and cardiacoutput were all negatively correlated with APACHE Ⅱ score (r=-0.970,-0.899,-0.922,all P<0.05), and the correlation coefficient between6h of oxygen uptake rate andAPACHE Ⅱ score is greater than that the lactate clearance rate and cardiac output withAPACHE Ⅱ score.Conclusions: In this experiment research we found that the early oxygen uptakerate to evaluate the severity and prognosis of ROSC patients is better than that of bloodlactate clearance rate and cardiac output; and the6h of oxygen uptake rate could be anindependent predictor of mortality in patients with cardiopulmonary resuscitation(CPR)recovery period; Compared to the APACHE Ⅱ score the step was trival, dataacquisition is difficult, the early oxygen uptake rate is more quickly and sensitive toevaluate the degree and the prognosis of the patients.