| Background Cardiac arrest(CA)is a sudden suspension of cardiac pump function caused by various reasons,which results in the termination of pulmonary circulation and large circulation of peripheral blood,thus causing craniocerebral injury.For patients with sudden cardiac arrest,timely and effective improvement of organ perfusion,correction of hypoxia in tissues,and restoration of normal cell function are the primary tasks and key points of treatment for patients with cardiac arrest,such as the heart and other important organs that affect the survival of the body.But cardiopulmonary resuscitation is still the most effective way to cure cardiac arrest,but after more than 60 years of research and development,the success rate of treatment is still poor.Pressure CPR is a new method of cardiopulmonary resuscitation proposed by Professor Wang Lixiang.This method can take both circulation and respiration into account during resuscitation,and it can also be used in some patients with contraindications of chest compression.The results of animal experiments show that this method is feasible in the early stage of cardiopulmonary resuscitation.However,there are few clinical studies on oxygen metabolism by this method.Purpose To compare the effects of abdominal pressure CPR and standard CPR on oxygenation function and prognosis,to observe the clinical therapeutic effect of abdominal pressure cardiopulmonary resuscitation(CPR).Methods From October 2015 to August 2017,98 patients with respiratory and cardiac arrest were treated in Zhengzhou people's Hospital.Patients who accord with the criteria were randomly divided into two groups: STD-CPR group and AACD-CPR group.The two groups were treated as follows: tracheal catheter was inserted via mouth,respiratory balloon assisted respiration,ECG monitoring,and Swan-Ganz catheter were placed.To establish an intravenous infusion of normal saline,electrical defibrillation is required for those who need defibrillation.Record Cardiac output(CO),Arterial oxygen content(Ca O2),mixed venous oxygen content(Cv O2),Dynamic-venous blood oxygen content difference(av DO2),Oxygen carrying capacity(DO2),Oxygen consumption(VO2),Oxygen Saturation of Mixed Venose Blood(Sv O2),blood pressure(BP),heart rate(HR),arterial blood gas(Arterial blood gas),The mean arterial pressure MAP,ROSC rate,ROSC 30 min,ROSC 60 min,ROSC time and 2-week clinical neurological impairment score(NDS and GCS)and 2 weeks survival rate.Results1.During the course of resuscitation,there was no significant difference between the two groups in CO,Cv O2(P > 0.05).AACD-CPR group in Ca O2,av DO2,DO2,VO2,Sv O2 was obviously higher than STD-CPR group(P < 0.05).Two groups in CO,Ca O2,av DO2,DO2,VO2,Sv O2,CO gradually rised,but CO growed slowly.2.Before resuscitation,Two groups base values in MAP,SPO2,Pa O2,Pa CO2,Lac,p H had no significant difference(P > 0.05).After resuscitation,two groups in MAP,SPO2,Pa O2 gradually rised,but gradually reduced in Pa CO2,Lac.Before and after resuscitation,the difference of SPO2,Pa O2,Pa CO2,Lac,p H between the two groups was statistically significant.(all P <0.05).3.The ROSC time of AACD-CPR group was significantly shorter than that of STD-CPR group(P < 0.05).AACD-CPR group had significantly higher ROSC rate,ROSC 30 min,ROSC 60 min and 2-week survival rate(P > 0.05).AACD-CPR group was significantly better than STD-CPR group(P >0.05).The difference was statistically significant(P < 0.05).Conclusion1.AACD-CPR in hemodynamic resuscitation effect was similar to STD-CPR,and in the changes of oxygen metabolism index were better than STD-CPR.2.AACD-CPR in rate of spontaneous circulation restoration was similar to that in STD-CPR,and in neural function prognosis was superior to STD-CPR. |
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