Objective To compare the changes of circulatory function within 72 h after restoration of spontaneous cir-culation (ROSC)between patients with cardiac arrest caused by central nervous system (CNS)impairment or non-CNS causes. Methods Twenty patients experiencing ROSC after cardiac arrest caused by CNS impairment (group A)and 17 patients with non-CNS causes (group B)were selected. We collected the heart rate,blood pressure,urine volume,the dif-ferent sorts of vasoactive drugs and so on at different points of time (admission to hospital,6 h,12 h,24 h,36 h,48 h and 72 h)after hospitalization. Meanwhile the arterial blood gas analysis results (including serum lactate )were collect-ed. Then the lactate clearance rate and oxygenation index (OI)were calculated. Results The blood lactate concentration tended to be normal at 72 h after ROSC started in all patients,and the lactate clearance rate was found the highest in the first 6 h. The lactate clearance rate of the first 6 h,and the first 24 h in the group A were found lower than those of group B,and the rate in 36-48 h after ROSC of group A was higher than that of group B (all P < 0. 05). The urine output volume of group A was significantly higher than that of the group B at 6-12 h,12-24 h,24-36 h,36-48 h,and 48-72 h (all P <0. 05 ). Twelve patients in group A still took vasoactive drugs,but only four patients in the group B took at 72 h,the per-centage of using vasoactive drugs of group A was higher than that of the group B (P < 0. 05). Conclusions The most sig-nificant improvement of circulation after ROSC within 72 h in patients with cardiac arrest is in the early stage. The circula-tion recovery of cardiac arrest patients with CNS impairment is relatively backward.%目的 对比观察中枢原因与非中枢原因心脏骤停患者自主循环恢复(ROSC)后72 h内循环功能变化.方法 选择中枢原因心脏骤停ROSC的患者20例纳入A组,非中枢原因心脏骤停ROSC的患者17例纳入B组.收集两组ROSC后0、6、12、24、36、48、72 h的心率(HR)、血压、尿量、使用血管活性药种类等资料.收集各时间点的动脉血气分析结果 (含乳酸值),进一步计算乳酸清除率及氧合指数(OI).结果所有病例ROSC后72 h血乳酸水平基本恢复正常,ROSC后0~6 h血乳酸清除率最高.A组ROSC后0~6 h、0~24 h乳酸清除率小于B组,36~48 h乳酸清除率大于B组(P均<0.05).A组ROSC后6~12 h、12~24 h、24~36 h、36~48 h、48~72 h尿量均大于B组(P均<0.05).ROSC后72 h A组使用血管活性药物12例,B组为4例,A组使用血管活性药物比例大于B组(P<0.05).结论 心脏骤停患者ROSC后72 h内越早期循环功能改善越明显;中枢原因心脏骤停患者较非中枢原因患者循环功能恢复相对滞后.
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