Study on the relationship between mechanical ventilation initiation time and prognosis of in-hospital cardiac arrest patients

Abstract

Objective To investigate the correlation between mechanical ventilation (MV) initiation time during cardiopulmonary resuscitation (CPR) and the prognosis of patients with in-hospital cardiac arrest (IHCA) in emergency. Methods Retrospective analysis of clinical records of patients with IHCA in emergency from January 2011 to April 2016 treated in Zhangye People's Hospital of Hexi University was performed. Patients with restoration of spontaneous circulation (ROSC) and were on MV with aged over 18 years were divided into early treated group (≤ 10 minutes) and later treated group (> 10 minutes) according to the initiation time of MV. Corneal reflex, pupillary reflex, pain-avoidance responses and motor response 24 hours after CPR, neurological function and cure rate of the two groups were analyzed. Results 210 patients were selected into our study including 130 males and 80 females (mean age: 60.24±13.17 years). There were no significant differences in gender, age, type of heart rate and etiological factor of cardiac arrest (CA) between the MV early stage group (124 cases) and the MV late stage group (86 cases). The restoration of corneal reflex, pupillary reflex, pain-avoidance responses, motor response and achievement ratio of CPR in early group were higher than those of later group (respectively, 59.68% vs. 31.40%, 59.68% vs. 31.40%, 54.84% vs. 24.42%, 54.84% vs. 24.42%, 70.16% vs. 51.16%, all P 0.05); The average hospitalized day of the early group was significantly shorter than that of the later group (days: 24.15±3.04 vs. 30.28±4.17, P < 0.01); Besides, the early group showed a higher survival rate at discharge and had more cases with neurologic level of grade 1-2 than those of the later group (Respectively, 41.94% vs. 26.74%, P < 0.05; 44.35% vs. 15.12%, P < 0.01). Conclusion Initiation MV on IHCA patients in the early stage of CPR (≤ 10 minutes) could help improve the hypoxic condition and prognosis of neurological function, and increase the achievement ratio of CPR. Key words: In-hospital cardiac arrest; Mechanical ventilation; Cardiopulmonary resuscitation; Prognosis