The Clinical Study Of Abdominal Lifting And Compression CPR Resuscitation Effect And Cerebral Function Prognosis

Objective(1)To compare the effect of STD-CPR and AACD-CPR on coronary artery perfusion and pulmonary ventilation.(2)To analyze the value of PetCO2 in predicting the outcome of patients with cardiac arrest.(3)By monitoring the changes of serum S100B and NSE protein during resuscitation,analyze the effects of two resuscitation methods on cerebral function of patients with cardiac arrest,and the prognostic value of serum S100B and NSE protein in cerebral function was comparatively analyzed retrospectively.Methods Inclusion criteria:(1)the cardiac arrest were accorded with the criteria for diagnosis of 2015 CPR cardiac arrest guidelines criteria;(2)Adolescent IHCA patients who were treated with AACD-CPR and STD-CPR;(3)Body weight 40-150 kg,sex unlimited.Exclusion Standard:(1)Cardiac arrest time exceeding 10 minutes and/or no CPR indication;(2)Patients with STD-CPR and/or AACD-CPR contraindication;(3)Patients who do not accept AACD-CPR treatment;(4)Patients who have severe respiratory,nervous and cardiovascular and other systemic diseases.CA patients who met the inclusion criteria were randomly divided into STD-CPR group and AACD-CPR group,and they were treated with STD-CPR and AACD-CPR,respectively.Results(1)the ROSC rates of STD-CPR group and AACD-CPR group were respectively 36.9%(24/65),41.5%(27/65),there was no significant difference between the two groups(?2=0.290,P=0.590).(2)with the progress of CPR,the hemodynamic indexes and blood gas analysis results of STD-CPR group and AACD-CPR group were improved significantly,and there was no statistical difference in HR,MAP,PaO2 between the two groups at different times(all P>0.05),The PaCO2 value of AACD-CPR group was significantly improved than that of STD-CPR group(P<0.05).(3)The PetCO2 value of AACD-CPR group was significantly improved than that of STD-CPR group at different times(all P>0.05),and the PetCO2 value of successful resuscitation patients and failed resuscitation patients in AACD-CPR group was significantly improved than that of STD-CPR group(P<0.05);PetCO2 value of successful resuscitation patients gradually increased to more than 20mmHg,and the PetCO2 value of failed resuscitation patients was not significantly increased or continued below 20mmHg.(4)The levels of serum S100B and NSE of patients with poor prognosis and good prognosis in STD-CPR group and AACD-CPR group were significantly higher than those in control group(all P<0.05),there was no statistical difference in serum S100B and NSE level between the good prognosis in both group and control group at 72h after ROSC(P>0.05),and there was statistical difference between the poor prognosis in both group and control group(P<0.05).The level of serum S100B and NSE of patients in poor prognosis was significantly higher than that of patients with good prognosis(all P<0.05).(5)There was no significant difference in serum S100B level between AACD-CPR group and STD-CPR group(P>0.05),and there was significant difference in serum NSE level between AACD-CPR group and STD-CPR group at 3h after ROSC(P<0.05);There was significant difference between STD-CPR group and STD-CPR group at 6h,24h,and 72h after ROSC(all P<0.05).(6)ROC curve analysis showed that the PetCO2 value at 20 minutes after CPR was 0.969(P=0.000),and the best critical value was 24.25mmHg,the sensitivity was 90.7%,the specificity was 96.6%;The AUC of the levels of S100B at 3h after ROSC and NSE at 6h after ROSC in predicting prognosis of cerebral function of patients with successful resuscitation were respectively 0.925,0.896(P=0.001,P=0.006);The best critical value were respectively 1.017ug/L,35.725ug/L;the sensitivity respectively were 83.4%,85.2%;the specificity respectively were 98.5%,85.5%.Conclusion(1)AACD-CPR is superior to STD-CPR on coronary artery perfusion and pulmonary ventilation;(2)PetCO2 changes can be used as an objective assessment index for clinical evaluation and prediction of the outcome of CPR resuscitation;(3)AACD-CPR is superior to STD-CPR on cerebral functional resuscitation,and serum S100B and NSE protein concentration changes can serve as an objective index to evaluate and predict the cerebral function prognosis of patients with CPR,which have certain reference significance for clinical resuscitation.