Study on the effect of mechanical compression and manual compression during cardiopulmonary resuscitation for cardiac arrest patients

Abstract

Objective To analyze the effect of mechanical press and manual press in cardiopulmonary resuscitation. Methods A prospective randomized controlled study was performed. A total of 95 cases who needed cardiopulmonary resuscitation were collected, according to the inclusion criteria, which including mechanical compression group (n= 48), and the manual compression group (n=47). Demographic, clinical course of two groups were collected. Arterial and venous blood gas analysis in the recovery after the start of 5 minutes, 15 minutes, 30 minutes, the end of recovery were also collected and the pH value, partial pressure of oxygen, extracellular base remaining, actual bicarbonate, lactic acid, calcium and central venous oxygen saturation (ScvO2) and other data were mainly analyzed. All data collation and statistical analysis were used Microsoft excel, SAS 9.4. The enumeration data were expressed by the frequency and percentage, and chi square test was used. The measurement data were expressed by mean and standard deviation, and t test was used. Multiple Logistic regression analysis was performed to analysis of the effect of various factors. Results There were no statistically differences in age and pathogenic factors between the mechanical compression group and manual compression group (P>0.05). The press time, success rate of resuscitation and hospitalization days were respectively (22±14) minutes, 81%, (37±16) days in the mechanical compression group and (27±19) minutes, 54%, (41±20) days in the manual compression group, with no statistically significant differences (all P>0.05). Mechanical compression group and manual compression group were cured in 17 cases, 10 cases, survived in 21 cases, 9 cases, deaded in 10 cases, 28 cases, with statistically significant differences between 2 groups (P<0.05). The troponin Ⅰ and creatine kinase MB were respectively (4.1±2.0) ng/ml, (31±15) U/L in the manual compression group and (5.6±1.9) ng/ml, (43±22) U/L in the mechanical compression group, with statistically significant differences between 2 groups (P<0.05). The defibrillation energy and defibrillation times in manual group were significantly higher than that of mechanical compression group (P<0.05). Multivariate logistic regression analysis showed that the central venous oxygen saturation at the first 5 minutes after the start of compression (χ2=65.0538, P<0.0001), the arterial blood pH at the end of compression (χ2=21.5779, P<0.0001), and the 5% sodium bicarbonate was significantly correlated with the prognosis of survival after resuscitation, mechanical compression group was better than the manual compression group (χ2=3.1421, P=0.0463). Conclusions The effect of cardiopulmonary resuscitation machine is better than that of manual compression, which can effectively improve the clinical treatment effect. The result recommends the use of cardiopulmonary resuscitation machine for patients with cardiac arrest. Key words: Cardiopulmonary resuscitation; Prognosis; Automatic cardiopulmonary resuscitation machine; Mechanical compression; Manual compression; Cardiac arrest