目的:研究猝死患者在心肺复苏过程中出现室性心率失常时胺碘酮的应用。方法:选心肺复苏过程中出现的室性心律失常患者共107例,随机分为治疗组57例采用胺碘酮治疗,对照组50例采用利多卡因治疗,持续心电监护观察其疗效。结果:治疗组、对照组有效率分别为93.1%、80.0%,有显著性差异。结论:胺碘酮组的疗效明显高于利多卡因组,在治疗心肺复苏过程中室性心律失常应首选胺碘酮。
目的:探讨心肺复苏循环恢复患者早期评估预后的相关因素。方法:对56例心肺复苏循环恢复患者进行病例回顾分析,分别记录患者年龄、性别以及心肺复苏循环恢复1小时内的瞳孔直径、格拉斯高昏迷评分、血WBC计数、血清肌酐Cr、血清丙氨酸氨基转移酶ALT、肌酸磷酸激酶、D-二聚体定性、血钙、血钾、血清淀粉酶、复苏后1小时内是否使用亚低温治疗、pH值、动脉血氧分压PaO2、动脉血二氧化碳分压PaCO2、血葡萄糖、复苏时间等, 采用多因素logistic回归模型分析心肺复苏循环恢复患者的预后因素。结果:回顾56例心肺复苏循环恢复患者病例, logistic回归分析发现血清淀粉酶、血糖和复苏时间对早期评估心肺复苏循环恢复患者的预后有意义。结论:复苏后1小时内血清淀粉酶、血糖和复苏时间对早期评估心肺复苏循环恢复患者的预后有价值。
ObjectiveTo find out the possible factors that may affect the survival time of patients undergoing return of spontaneous circulation (ROSC) within seven days of cardio-pulmonary resuscitation. MethodWe retrospectively collected 20 clinical indicators from 51 patients who underwent ROSC after cardio-pulmonary resuscitation in Emergency Department between August 2013 and February 2015. The indicators included gender, age, duration of cardio-pulmonary resuscitation, blood pressure acquired immediately after ROSC, heart rate, respiration, lactic acid, creatinine, prothrombin time, bilirubin, pH, arterial partial pressure of carbon dioxide, potassium, sodium, blood glucose, atrial natriuretic peptides, leukocyte, platelets, and hemoglobin. Then we analyzed the correlation of these indicators with survival time through Cox regression model. ResultsThe results showed that duration of cardiopulmonary resuscitation[RR=1.053, 95% CI (1.020, 1.088), P=0.002] and systolic blood pressure acquired immediately after ROSC[RR=0.991, 95% CI (0.982, 0.999), P=0.038] significantly affected the survival time of patients after ROSC. ConclusionsDuration of cardiopulmonary resuscitation and systolic blood pressure acquired immediately after ROSC may be useful in predicting the survival time of patients after ROSC.
This paper introduces the development and animal tests of a miniaturized electrical chest compression device. Based on pulse width modulation technology produced by micro control unit, the device can control the frequency and depth of the compression accurately, as well as perform real-time adjustment. Therefore, it can perform continuous and stable chest compression for long time, which may increase the successful rate of cardiopulmonary resuscitation (CPR). Besides, the device can also produce different types of compression waveforms, including trapezoidal and triangular waveforms. Then, the performance and efficacy of the device was assessed with a rat model of asphyxial cardiac arrest (CA).
The inspiratory impedance threshold device (ITD) was put forward by Lurie in 1995, and was assigned as a class Ⅱa recommendation by the International Liaison Committee on Resuscitation (ILCOR) resuscitation guidelines in 2005. The ITD is used to augment negative intrathoracic pressure during recoil of the chest so as to enhance venous return and cardiac output, and to decrease intracranial pressure. In the recent years many researches on the ITD have been1 carried out, but all the researches can not take out a clear evidence to support or refute the use of the ITD. This paper introduces the structure and working principle of the ITD in detail, the research results and the debates about the use of the ITD for the past years.
Sudden cardiac arrest is one of the critical clinical syndromes in emergency situations. A cardiopulmonary resuscitation (CPR) is a necessary curing means for those patients with sudden cardiac arrest. In order to simulate effectively the hemodynamic effects of human under AEI-CPR, which is active compression-decompression CPR coupled with enhanced external counter-pulsation and inspiratory impedance threshold valve, and research physiological parameters of each part of lower limbs in more detail, a CPR simulation model established by Babbs was refined. The part of lower limbs was divided into iliac, thigh and calf, which had 15 physiological parameters. Then, these 15 physiological parameters based on genetic algorithm were optimized, and ideal simulation results were obtained finally.
ObjectiveTo investigate the effects of different peak flow on the airway pressure to explore a preferable value of peak flow in ventilation during cardiopulmonary resuscitation (CPR) under volume control ventilation (VCV) mode and decreasing-wave. Methods30 patients who underwent CRP in the emergency unit between January 2012 and 2014 was recruited in the study. When the chest compressions came into a stable state by a same doctor,the peak flow was set at 50 L/min and 30 L/min respectively while other parameters fixed in the same patient. Then the pressure-time curve of a respiratory cycle was randomly frozen to achieve the highest peak pressure in inspiratory phase. ResultsThe highest peak airway pressures were (54.1±4.9)cm H2O and (35.5±5.3)cm H2O when the peak flow were set at 50 L/min and 30 L/min respectively with significant difference. The incidence of peak airway pressure greater than 40 cm H2O was 96.7% and 26.7%,and the incidence of peak airway pressure greater than 50 cm H2O was 76.7% and 0%,respectively. Compared with 50 L/min,the peak flow of 30 L/min obviously reduced the peak pressure (P=0.000). ConclusionIn the mechanical ventilation during CPR using VCV mode and decreasing-wave,compared with peak flow of 50 L/min,smaller peak flow of 30 L/min can significantly reduce peak airway pressure,and significantly reduce the adverse effects to ventilation by repeated violent changes in airway pressure caused by continuing chest compressions,and make airway peak pressure under 40 cm H2O in most patients,so it is a reasonable and safe choice.
Artifacts produced by chest compression during cardiopulmonary resuscitation (CPR) seriously affect the reliability of shockable rhythm detection algorithms. In this paper, we proposed an adaptive CPR artifacts elimination algorithm without needing any reference channels. The clean electrocardiogram (ECG) signals can be extracted from the corrupted ECG signals by incorporating empirical mode decomposition (EMD) and independent component analysis (ICA). For evaluating the performance of the proposed algorithm, a back propagation neural network was constructed to implement the shockable rhythm detection. A total of 1 484 corrupted ECG samples collected from pigs were included in the analysis. The results of the experiments indicated that this method would greatly reduce the effects of the CPR artifacts and thereby increase the accuracy of the shockable rhythm detection algorithm.