Clinical Application Of Active Abdominal Compression-decompression Cardiopulmonary Resuscitation Technique

Background and Objective:Cardio pulmonary resuscitation（CPR）is a method of resuscitating patients in cardiac arrest（CA）with artificial respiration and circulation instead of voluntary respiration and circulation.Patients resuscitated by standard cardiopulmonary resuscitation（STD-CPR）have the potential to restore voluntary circulation restoration of spontaneous circulation（ROSC）and respiration.However,the practical challenge of how to improve the success rate of CPR in patients has not yielded promising results.Active abdominal compression-decompression cardiopulmonary resuscitation（AACD-CPR）is a method in which an abdominal compression-decompression cardiopulmonary resuscitator is placed on the abdomen of a patient in cardiac arrest,and active lifting and compressions are combined to The method of AACD-CPR is to force the pressure in the thoracic and abdominal cavities to change,forming an artificial circulation with a pressure difference and being able to take into account artificial respiration to achieve the effect of resuscitation.This paper proposes a comparative study of the changes in hemodynamic and oxygenation indices between AACD-CPR and standard STD-CPR to make an objective and fair assessment of the clinical effectiveness of abdominal compression CPRMethods:1.Study methods:48 patients with cardiac arrest admitted to the emergency department of the First Hospital of Hebei Medical University between March2019 and December 2019 were selected.With 24 patients in each group,and the experimental group was implemented with AACD-CPR technique,and the control group was implemented STD-CPR by an automatic CPR machine.In both groups,patients were routinely intubated through the mouth under visualization,ventilator-assisted mechanical ventilation,comprehensive ECG monitoring,establishment of intravenous access,and defibrillation for patients who needed defibrillation,and other related treatment was performed in accordance with the American Heart Association（AHA）2015 CPR guidelines.2.Observation indexes:Blood pressure（BP）,heart rate（HR）,mean arterial pressure（MAP）,PH,PaO₂,PaCO₂,partial pressure of end-tidal carbon dioxide（PETCO₂）of patients after the patient’s autonomic circulation were recorded.The effectiveness of the two resuscitation methods was compared by recording the mean resuscitation time,the rate of recovery of autonomic circulation（ROSC evaluation criteria:patient’s ECG or monitor suggests normal or supraventricular rhythm maintained for≥20 minutes,during which MAP≥50mm Hg）,etc.The safety of the two resuscitation methods was compared by the incidence of complications in the two groups.Results:（1）There was no statistically significant difference between the two groups in terms of gender and age（P>0.05）,and they were comparable.（2）Ten cases recovered voluntary circulation in the STD-CPR group and 9 cases recovered voluntary circulation in the AACD-CPR group,and the mean arterial pressure（MAP）and heart rate（HR）conditions after successful resuscitation in the AACD-CPR group were better than those in the STD-CPR group,and the difference in MAP was statistically significant（P<0.05）;while the oxygenation in the AACD-CPR group was better than that of the STD-CPR group,and the differences in Pa0₂、PaCO₂ and PH were statistically significant（P<0.05）,and the difference in PETCO₂ statistics between the two groups was small（P>0.05）and not statistically different.（3）The mean resuscitation success time in the STD-CPR group was（34.80±6.70）minutes,and the mean resuscitation success time in the AACD-CPR group was（23.33±7.07）minutes,and the differences were statistically significant（P<0.05）;the ROSC rate in the STD-CPR group was slightly higher than that in the AACD-CPR group,but the differences were not statistically significant（P>0.05）.During the resuscitation process,the stability,safety and portability of the abdominal compressional cardiopulmonary resuscitator were fully affirmed by all participating medical personnel,and no serious adverse reactions or secondary injuries occurred during the trial.Conclusion:According to the results of the study,we can conclude that the resuscitation effect of the AACD-CPR group is relatively good compared with that of the STD-CPR group;at the same time,the application of the abdominal compressional CPR device adds a new member to the CPR method,providing a convenient and safe and effective means of first aid.