Study on the Effects of Optimized Emergency Nursing Combined with Mild Hypothermia Nursing on Neurological Prognosis, Hemodynamics, and Cytokines in Patients with Cardiac Arrest.

Abstract

Purpose To study the effects of optimized emergency nursing combined with mild hypothermia nursing on neurological prognosis, hemodynamics, and cytokines in patients with cardiac arrest (CA). Methods The medical records of 147 patients who were successfully rescued by cardiopulmonary resuscitation (CPR) after CA in our hospital were retrospectively analyzed. The 56 patients admitted in 2020 who received optimized emergency nursing were recorded as the control group; and the 91 patients admitted in 2021 who received optimized emergency nursing combined with mild hypothermia nursing were recorded as the study group. The brain function of the two groups at 72 h after return of spontaneous circulation (ROSC) was analyzed: cerebral performance category (CPC) assessment method. The neurological function of the two groups before nursing and 7, 30, and 90 d after nursing was analyzed: National Institutes of Health Stroke Scale (NISHH) score. The vital signs of the two groups after 24 h of nursing were analyzed: heart rate, spontaneous breathing rate, and blood oxygen saturation. The hemodynamic indexes of the two groups at 24 hours after nursing were analyzed: mean arterial pressure (MAP), central venous pressure (CVP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The levels of cytokines of the two groups before nursing and 7 days after nursing were analyzed: tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8). The incidence of complications and the incidence of postresuscitation syndrome (PRS) during the nursing period were compared between the two groups. Results 72 h after ROSC, the CPC results in the study group were slightly better than those in the control group, but there was no significant difference in the number of cases of CPC Grade 1, CPC Grade 2, CPC Grade 3, CPC Grade 4, and CPC Grade 5 between the two groups (P > 0.05). Before nursing, there was no statistical difference in the NISHH total score between the two groups (P > 0.05). 7, 30, and 90 d after nursing, the NISHH total score between the two groups were lower than those before nursing, and the study group's score was lower than the control group's (P < 0.05). 24 h after nursing, the heart rate and spontaneous breathing rate of the study group were lower than those of the control group (P < 0.05), and there was no significant difference in blood oxygen saturation between the two groups (P > 0.05). 24 h after nursing, there was no significant difference in MAP, CVP, SBP, and DBP between the two groups (P > 0.05). Before nursing, there was no significant difference in the levels of TNF-α, IL-6, and IL-8 between the two groups (P > 0.05). 7 d after nursing, the levels of TNF-α, IL-6, and IL-8 between the two groups were lower than those before nursing, and the levels of the study group were lower than those of the control group (P < 0.05). During the nursing period, the total complication rates of the control group and the study group were 55.36% and 34.07%, respectively, with statistical difference (P < 0.05). During the nursing period, the incidences of PRS in the control group and the study group were 12.50% and 3.30%, respectively, with significant difference (P < 0.05). Conclusion The application of optimized emergency nursing combined with mild hypothermia nursing in CA can effectively improve the neurological prognosis and inflammatory levels of patients and reduce the incidence of body complications and PRS.