Objective To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma.Methods Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled,and they were divided into abdominal lifting and compression group (n =32) and unarmed abdominal compression group (n =34) by random number table.The patients in both two groups were given the airway open,respiration support,defibrillation treatment,venous access establishment,vasoactive drugs application and other conventional treatments.On the basis of the routine treatment,the patients in abdominal lifting and compression group were given application of abdominal lifting and compression device with 100 times/min frequency and continuously alternating press down to lift the abdomen,the amplitude of pressing and pulling were 3-5 cm below or above the original level of the abdomen.Those in unarmed abdominal compression group were given abdominal CPR pressing method by hand,the frequency of pressing and depth of subsidence was the same as abdominal lifting and compression group.Heart rate (HR) and arterial blood gas at 30 minutes after CPR as well as the success rate of resuscitation were compared between the two groups.The changes in HR,mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) before and 30 minutes and 60 minutes after CPR were dynamically observed in patients with restoration of spontaneous circulation (ROSC) after abdominal lifting and compression CPR treatment.Results Compared with the unarmed abdominal compression group,HR (bmp:136.13±6.14 vs.148.45±5.16) and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg =0.133 kPa):48.51 ±2.60 vs.62.51 ±2.50] at 30 minutes after CPR in abdominal lifting and compression group were significantly lowered,and arterial partial pressure of oxygen (PaO2) was significantly increased (mmHg:88.07±3.92 vs.74.12±2.12,all P ＜ 0.05).Four patients with ROSC were found in abdominal lifting and compression group,and 2 in unarmed abdominal compression group.The success rate of resuscitation in abdominal lifting and compression group was significantly higher than that of unarmed abdominal compression group (12.50％ vs.5.82％,P ＜ 0.05).In 4 patients with ROSC after abdominal lifting and compression CPR showed a downward trend in HR and an upward trend in MAP and SpO2 with CPR time prolongation.Conclusions The effect of abdominal lifting and compression CPR is better than that of unarmed abdominal compression CPR,which is of great value for the life saving of patients with breathing and cardiac arrest induced bv severe chest trauma.

Objective To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest.Methods Forty-five patients with respiratory and cardiac arrest,and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled,and they were divided into two groups according to random number table.AACD-CPR (abdominal compression-decompression group,n =24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group,n =21) were performed respectively.The success rate of rescue was observed in the two groups,and the changes in heart rate (HR),pulse oxygen saturation (SpO2) and blood pressure 30 minutes after CPR in patients with restoration of spontaneous circulation (ROSC) were observed.Results Among the 24 patients in the abdominal compression-decompression group,5 patients (20.83％) had ROSC,and 2 patients (9.52％) had ROSC in 21 patients of the unarmed abdominal pressure group.The success rate of resuscitation in the abdominal compression-decompression group was significantly higher than that in the unarmed abdominal pressure group (P ＜ 0.05).HR of ROSC patients at 30 minutes of CPR in abdominal compression-decompression group was significantly lower than that in unarmed abdominal compression group (bpm:139.45±5.08 vs.147.62±5.24,P ＜ 0.05),and SpO2 and blood pressure were significantly higher than those in unarmed abdominal compression group with significant differences [SpO2:0.92 ± 0.03 vs.0.85 ± 0.03,systolic blood pressure (SBP,mmHg,1 mmHg =0.133 kPa):118.23 ± 3.26 vs.98.51 ± 3.10,diastolic blood pressure (DBP,mmHg):60.10 ± 2.50 vs.56.36 ± 2.45,all P ＜ 0.05].Conclusion The effect of AACD-CPR was superior to that of unarmed abdominal pressure CPR,which had higher application value to rescue patients with respiratory and cardiac arrest with chest pressure contraindication.