1.Comparative study for effects of bare-handed CPR with Thumper cardiopulmonary resuscitator CPR in emergency department based on "the Utstein style"
Chongyang ZHANG ; Yaohui WANG ; Hongwei LIU ; Aixiang HAO ; Junxiang XUN ; Qingyi MENG
Chinese Critical Care Medicine 2017;29(10):937-939
Objective To objectively and standardly compare the bare-handed CPR and Thumper cardiopulmonary resuscitation CPR recovery effect based on cardiopulmonary resuscitation (CPR) Utstein model.Methods A retrospective study was conducted. CPR adult patients admitted to the Emergency Room of First Hospital of Qinhuangdao in Hebei Province from January 2015 to January 2017 were enrolled. Seventy patients who underwent CPR using the Thumper cardiopulmonary resuscitator were included in the Thumper CPR group; 80 patients who underwent manual hand-held CPR were included in the bare-handed CPR group. Return of spontaneous circulation (ROSC) and return of spontaneous breathing, and blood gas analysis indexes of recovery for 5 minutes and 15 minutes [arterial oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2), arterial blood oxygen saturation (SaO2), blood lactic acid (Lac)] were collected.Results There was no significant difference in gender, age and cardiac arrest (CA) causes between the two groups. Compared with the bare-handed CPR group, the ROSC rate in the Thumper CPR group was significantly increased [68.57% (48/70) vs. 51.25% (41/80),χ2 = 4.642,P = 0.031], but there was no significant difference in return of spontaneous breathing rate [48.57% (34/70) vs. 47.50% (38/80),χ2 = 0.017,P = 0.896]. There was no significant difference in blood gas index between the two groups after 5 minutes of recovery. The PaO2 and SaO2 in the Thumper CPR group were significantly higher than those in the bare-handed CPR group [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 88.13±5.06 vs. 84.26±5.53, SaO2: 0.828±0.068 vs. 0.766±0.031, bothP < 0.05), PaCO2 and Lac were significantly lower than those in the bare-handed CPR group [PaCO2 (mmHg):34.04±4.62 vs. 40.43±5.29, Lac (mmol/L): 6.90±2.07 vs. 8.50±2.12, bothP < 0.05].Conclusions In the process of emergency rescue, Thumper cardiopulmonary resuscitator is more successful than bare-handed CPR. The recovery rate of Thumper cardiopulmonary resuscitator is more conducive to save manpower and obtain better metabolic effect, which is worthy of clinical promotion and application.
2.Evidence-based Prognosis for Patients with Postpartum HEELP Syndrome complicated with Acute Renal Failure
Aixiang TAN ; Xiaoyang DENG ; Xiaoling LONG ; Qiukui HAO
Journal of Shenyang Medical College 2016;18(5):344-346
Objective:To provide clinical evidence-based prognosis for patients with postpartum HEELP syndrome complicated with acute renal failure. Methods:The clinical question was proposed. Some database was searched to assess the evidence. Results:A total of 4 studies were included,however,the quality of the studies was low. The results of the studies was suitable for our patients. The death of patients with postpartum HEELP syndrome complicated with acute renal failure was attributed to multiple organ failure. The risk factors for poor prognosis was primipara, delivery after twin pregnancy, absence of typical symptoms, rapid clinical progression, high blood pressure, epigastric pain. Early assessment and diagnosis for maternal and infant, positive in intervention and be caution for the DIC and multiple organ failure, using plasmapheresis can improve the prognosis. Conclusion:Patients with postpartum HEELP syndrome complicated with acute renal failure have an acute process and poor prognosis, especially for patients without typical symptoms.