摘要
目的心肺复苏质量指数(cardiopulmonary resuscitation quality index,CQI)基于脉搏血氧波形(pulse oximetry plethysmographic waveform,POP),在心肺复苏(cardiopulmonary resuscitation,CPR)中能够实时监测外周循环状态,体现胸外按压质量。已证实CQI对CPR患者预后评估非劣效于呼气末二氧化碳分压(partial pressure of end-tidal carbon dioxide,PETCO2)。本研究目的旨在探究高级气道建立是否影响CQI在CPR过程中对于患者预后的判断价值。方法前瞻性描述性研究。以376例心肺复苏患者为研究对象,根据是否建立高级气道分为高级气道组和非高级气道组,根据是否恢复自主循环(return of spontaneously circulation,ROSC)分为ROSC组和非ROSC组。记录复苏过程中CQI和PETCO2变化,观察上述参数对患者预后评估的价值。结果:高级气道组中CQI[(63.3±20.7)vs(49.7±23.8)],PETCO2[19.8(11.4,31.6)mmHg vs8.8(3.3,15.8)mmHg]在ROSC组和非ROSC组间均有统计学意义(P<0.05),其对预后评估的最佳截断点分别为60.4和16.3,其ROC曲线下面积差异无统计学意义(P>0.05)。非高级气道组CQI[(63.0±21.8)vs(42.2±29.0)]在ROSC组和非ROSC组间有统计学意义(P<0.05),其对预后评估的最佳截断点分别为61.1。高级气道组与非高级气道组间CQI对预后评估的曲线下面积差异无统计学意义(P>0.05)。结论CQI可用于CPR过程评估患者预后,其评估效力非劣效于与PETCO2;高级气道建立与否不影响CQI对CPR患者的预后评估。
Objective Cardiopulmonary resuscitation quality index(CQI)is based on pulse oximetry plethysmographic waveform(POP),which have been proved able to reflect the peripheral circulation state as good as the quality of chest compression during cardiopulmonary resuscitation(CPR).It has been confirmed that CQI is as good as the partial pressure of end-tidal carbon dioxide(PETCO2)in prognostic evaluation of CPR patients.The purpose of this study was to explore whether advanced airway establishment affects the prognostic value of CQI during CPR.Methods This was a prospective descriptive study.376 patients receiving CPR were divided into advanced airway group and non-advanced airway group according to whether advanced airway was established,each of which was divided into ROSC(return of spontaneous circulation)group and non-ROSC group according to whether they got ROSC.The changes of CQI and PETCO2 during CPR were collected,and the relation of these parameters and the prognosis of patients was analyzed.Results In advanced airway group,both CQI[(63.3±20.7)vs(49.7±23.8)]and PETCO2[19.8(11.4,31.6)vs 8.8(3.3,15.8)]mmHg were statistically different between ROSC group and non-ROSC group(P<0.05).The cut-off value for these two parameters were 60.4 and 16.3 mmHg respectively.There was no significant difference between the two curves(P>0.05).In the non-advanced airway group,CQI[(63.0±21.8)vs(42.2±29.0)]were also statistically different between the ROSC group and the non-ROSC group(P<0.05).The cut-off value of CQI in advanced airway group and non-advanced airway group were 60.4 and 61.1,respectively.And there was no statistical difference between the two curves(P>0.05).Conclusions During CPR,CQI can be used to evaluate the prognosis of patients,which is as good as that of PETCO2-Establishment of advanced airway does not affect the prognostic evaluation of CQI during CPR.
作者
李晨
徐军
付阳阳
韩飞
柴艳芬
寿松涛
于学忠
Li Chen;Xu Jun;Fu Yang-yan;Han Fei;Chai Yan-fen;Shou Song-tao;Yu Xue-zhong(Department of emergency,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of emergency,Peking Union Medical College Hospital of Chinese Academy of Medical Sciences,Peking 100730,China;Institute of Life Monitoring,Mindray Corporation,Shenzhen 518057,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2020年第2期257-261,共5页
Chinese Journal of Emergency Medicine
基金
国家卫生计生委公益性行业科研专项项目(201502019)。
关键词
心脏骤停
心肺复苏
高质量胸外按压
脉搏血氧波形
心肺复苏质量指数
呼气末二氧化碳分压
预后
自主循环恢复
Cardiac arrest
Cardiopulmonary resuscitation
High-quality chest compressions
Pulse oximetry plethysmographic waveform
Cardiopulmonary resuscitation quality index
Partial pressure of end-tidal carbon dioxide
Prognosis
Return of spontaneously circulation
