Clinical effect of cardiopulmonary resuscitation with active abdominal compression-decompression
10.3760/cma.j.issn.2095-4352.2019.02.021
- VernacularTitle:腹部提压心肺复苏临床效果分析
- Author:
Feng ZHAN
1
;
Wei SONG
;
Jun ZHANG
;
Min LI
;
Wenteng CHEN
Author Information
1. 海南省人民医院急救中心EICU
- Keywords:
Cardiopulmonary resuscitation;
Active abdominal compression-decompression;
Restoration of spontaneous circulation
- From:
Chinese Critical Care Medicine
2019;31(2):228-231
- CountryChina
- Language:Chinese
-
Abstract:
Objective? To?explore?the?resuscitation?effect?of?active?abdominal?compression-decompression?cardiopulmonary?resuscitation?(AACD-CPR)?on?patients?with?cardiac?arrest.? Methods? The?patients?with?cardiac?arrest?admitted?to?emergency?medical?center?of?Hainan?General?Hospital?from?June?2014?to?January?2016?were?enrolled,?who?were?satisfied?with?the?indication?of?AACD-CPR?and?had?no?contraindication?for?AACD-CPR,?and?with?40-150?kg?weight?and?over?16?years?old.?All?of?enrolled?patients?were?given?mechanical?ventilation?and?conventional?drug?rescue.?At?the?same?time,?AACD-CPR?was?performed?with?the?active?abdominal?compression-decompression?device,?the?rhythm?of?abdominal?compression-decompression?was?100?bmp?and?the?ratio?of?compression?time?to?lift?time?was?1∶1,?the?pressure?intensity?was?approximately?50?kg?and?the?lifting?intensity?was?approximately?30?kg.?Heart?rate?(HR),?mean?arterial?pressure?(MAP),?pulse?oxygen?saturation?(SpO2)?and?blood?lactic?acid?(Lac)?were?recorded?before?and?after?CPR,?and?restoration?of?spontaneous?circulation?(ROSC)?were?calculated.? Results? Forty-one?patients?with?cardiac?arrest?were?enrolled,?with?22?males?and?19?females,?and?the?age?between?15?years?old?and?89?years?old,?with?an?average?(66.5±?18.8)?years?old.?The?etiologies?of?cardiac?arrest?were?followed:?cardiogenic?for?10?cases,?non-cardiogenic?for?18?cases,?and?unknown?causes?for?13?cases.?The?rate?of?ROSC?in?patients?with?AACD-CPR?was?19.5%?(8/41).?During?the?resuscitation,?the?HR,?MAP?and?SpO2?of?those?patients?were?significantly?improved?compared?with?those?index?suffering?the?cardiac?arrest?[HR?(bmp):?67.0?(48.0,?105.0)?vs.?0.0?(0.0,?11.5),?MAP?(mmHg,?1?mmHg?=?0.133?kPa):?23.0?(16.0,?37.0)?vs.??0.0?(0.0,?0.0),?SpO2:?0.79?(0.45,?0.90)?vs.?0.00?(0.00,?0.32),?all?P?0.01].?During?the?resuscitation?and?0.5?hours?after?ROSC,?the?indexes?of?the?ROSC?patients?were?significantly?improved?compared?with?those?suffering?cardiac?arrest?[HR?(bmp):?88.5?(53.8,?105.0),?94.5?(72.5,?129.3)?vs.?0.0?(0.0,?17.3);?MAP?(mmHg):?48.0?(41.3,?66.0),?54.0?(42.0,?72.5)?vs.??0.0?(0.0,?0.0);?SpO2:?0.74?(0.64,?0.80),?0.89?(0.81,?0.93)?vs.?0.00?(0.00,?0.42);?all?P 0.05];?in?addition,?the?Lac?of?patients?was?not?increased?in?the?resuscitation?and?0.5?hours?after?ROSC?compared?with?the?status?before?cardiopulmonary?resuscitation?(mmol/L:?4.44±1.66,?3.71±1.33?vs.?3.95±1.71,?both P >?0.05).?Besides,?the?ROSC?rate?of?patients?who?suffered?cardiac?arrest?before?pre-hospital?care?or?in?emergency?ward?[11.1%?(2/18)]?were?lower?than?those?the?patients? who?suffered?cardiac?arrest?in?emergency?intensive?care?unit??[EICU,?26.1%?(6/23)];?while?the?cardiac?arrest?patients?who?didn't?experienced?AACD-CPR?until?they?got?complications?such?as?thoracic?rib?fracture?after?standard?cardiopulmonary?resuscitation?(STD-CPR),?the?ROSC?rate?of?those?patients?in?pre-hospital?care?or?in?emergency?ward?[10.0%?(1/10)]?were?lower?than?the?ROSC?rate?of?the?patients?who?suffered?cardiac?arrest?in?EICU?[20.0%?(4/20)],?but?there?was?no?significant?difference?between?the?two?groups?(both?P?>?0.05).? Conclusion? AACD-CPR?is?effective?in?the?treatment?of?sudden?cardiac?arrest?patients?with?contraindication?of?chest?compression,?and?makes?up?for?the?deficiency?of?STD-CPR.