1.Influence of simulated high altitude environment on the basic vital signs of CPR rescuers
Xin ZHOU ; Xinyu LI ; Zheqi FANG ; Yuying WEI ; Lei ZHANG ; Zhengxiong LIU
Medical Journal of Chinese People's Liberation Army 2017;42(7):652-655
Objective To observe the influence of different altitudes on the basic vital signs of cardiopulmonary resuscitation (CPR) rescuers before and after CPR.Methods The experiment was completed in the Simulated Cabin for Special Environment of Northwest of China. Ninety healthy adult medical staff in General Hospital of Xinjiang Command were randomly and equally divided into 3 groups: plain (normal oxygen), 3700-meter high altitude and 4300-meter high altitude. According to the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the values of heart rate (HR), mean arterial pressure (MAP), respiration rate (RR), arterial oxygen saturation (SpO2), before and after 1 CPR cycle were recorded for statistical analysis and their changes were compared.Results The HR and RR significantly increased (P<0.05), but MAP and SpO2 did not change significantly (P>0.05) in the three groups. The HR and RR was faster in 4300 meter high-altitude than in 3700 meter high-altitude (P<0.05), and was faster in 3700 meter high-altitude than in the plain (P<0.05). But there was no significant difference between the three groups in MAP and SpO2 (P>0.05).Conclusions With the elevation of the altitude, HR and RR may significantly increase in CPR rescuers, but there is no significant influence on MAP and SpO2.
2.The predictive values of complement C3, C4 and cholesterol levels for prognosis of patients with sepsis
Zongren AN ; 天津市天津医院 ; Zhengxiong LIU ; Lei ZHANG ; Xin ZHOU ; Zheqi FANG ; Menghua LUO ; Xinyu LI
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(5):456-459
Objective To investigate the predictive values of serum complement C3, C4 and cholesterol levels in the prognosis of patients with sepsis. Methods The clinical data of all the patients with sepsis admitted to the Department of Critical Care Medicine of the General Hospital of Xinjiang Military Command from January 2015 to January 2017 were retrospectively analyzed. The levels of serum complement C3, C4, cholesterol, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure score (SOFA), etc. were recorded within 24 hours after admission, the patients were divided into survival group and death group according to the 28-day prognosis, and the differences in various indexes between the two groups were compared respectively;the predictive efficacies of C3, C4 and cholesterol levels in the prognosis of sepsis patients were evaluated by plotting receiver operating characteristic curves (ROC). Results Finally, 120 patients with sepsis were enrolled, including 57 patients in the survival group and 63 patients in the death group. Compared with the survival group, the APACHE Ⅱscore and the SOFA score of the death group were increased significantly (APACHE Ⅱ score: 20.29±5.90 vs. 15.32±5.98, SOFA score: 7.62±3.11 vs. 5.16±2.50, both P < 0.01), however, serum C3, C4 and cholesterol levels were obviously decreased [C3 (g/L): 0.67±0.22 vs. 0.82±0.24, C4 (g/L): 0.17±0.05 vs. 0.20±0.06, cholesterol (mmol/L): 2.77±1.23 vs. 3.46±1.02, all P < 0.01]. ROC curve analyses showed: each of the following items, complement C3, C4, and cholesterol, alone predicting the prognosis of sepsis patients, the area under ROC curve (AUC) and 95% confidence interval (95%CI) were as follows: AUC = 0.680 (95%CI = 0.583-0.777, P = 0.001), AUC =0.657 (95%CI = 0.560-0.754, P = 0.003), and AUC = 0.711 (95%CI = 0.619-0.804, P < 0.001) respectively; when complement C3, C4 and cholesterol combination to predict the prognosis of patients with sepsis, the resulting predictive value was better than the predictive value results obtained by each one of the items or each combination of any two of them (the AUC of C3+C4+cholesterol was 0.725, 95%CI = 0.633-0.817, P < 0.001; the AUC of C3+C4 was 0.697,95%CI = 0.603-0.791, P < 0.001; the AUC of C3 + cholesterol was 0.718, 95%CI = 0.626-0.811, P < 0.001; the AUC of C4+cholesterol was 0.722, 95%CI = 0.629-0.815, P < 0.001). Conclusion Using combination of serum complement C3, C4 and cholesterol levels to predict the prognosis of patients with sepsis may obtain important predicting value, that can provide a reference to clinical doctors.