Abstract
Objective To analyze the clinical value of the end tidal carbon dioxide partial pressure (PETCO2 ) in evaluating the efficacy of abdominal lifting and compression CPR in patients with cardiac arrest. Methods Ninety-two patients with cardiac arrest were selected from September 2014 to October 2016. All patients underwent oral endotracheal intubation whose distal end of trachea cannula were connected to a CO2 infrared detector monitoring the heart rate (HR), mean arterial pressure (MAP), blood gas analysis of arterial oxygen partial pressure (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) before, during and after abdominal lifting and compression CPR. PETCO2 of CPR was also monitored at different time points dynamically. Meanwhile, the time from the beginning of CPR to the restoration of spontaneous circulation (ROSC) was recorded. All patients were divided into success group and failure group according to the ultimate outcome of CPR, the number of patients with 30-min and 60-min survival was recorded and the recovery success rate calculated in the success group. Finally, the factors affecting the success rate of abdominal lifting and compression CPR were retrospectively analyzed. Results At the beginning of CPR, the PETCO2 value in both groups was about 9-10 mmHg, with insignificant difference between the two groups (P>0.05). The PETCO2 value in success group was rising gradually during the abdominal lifting and compression CPR process, and increased slightly at 2-5 min but then gradually decreased in the failure group. The average value of PETCO2 was larger than 20 mmHg in the success group but was lower than 20 mmHg in the failure group, with significant difference between two groups (P<0.05). There was significant difference in the results of blood gas analysis between CPR process and beginning of CPR (P< 0.05). The difference of MAP, PaO2 and PaCO2 20 minutes after ROSC was statistically significant compared with abdominal lifting and compression CPR process (P< 0.05). The recovery success rate of 30 min and 60 min after ROSC was both 17.4% (16/92) in the success group. The Cardiac arrest caused by traumatic disease and cerebral diseases was closely related to the cardiopulmonary resuscitation success or not (P<0.05). The successful resuscitation via abdominal lifting and compression CPR in CA patients was 37 cases (40.22%). The time for successful recovery of patients with ROSC was (10.20±3.52)min, shorter than [(23.70±5.20)min] in failure group, with statistically significant difference between two group (t=-13.796, P< 0.05). Conclusion The variation of PETCO2 value can be used as a clinical index to evaluate and forecast the success rate of abdominal lifting and compression CPR. Cardiopulmonary resuscitation success rate is low for abdominal lifting and compression CPR in traumatic or cerebral-induced CA patients. The ROSC time is negatively correlated with the ROSC rate. Key words: Abdominal lifting and compression; Cardiopulmonary resuscitation; Restoration of spontaneous circulation; End tidal carbon dioxide partial pressure
Published Version
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