胸外按压器械AutoPulse及PetCO2、脉搏、SPO2监测在急诊CPR中的应用评价

摘要

Objective To evaluate the application of AutoPulse and monitoring of end-tidal carbon dioxide partial pressure ( PetCO2) and pulse oxygen saturation (SPO2) in patients with cardiac arrest (CA) undergoing PCR. Methods Ninety three patients with CA admitted to Emergency Department from December 2010 to December 2011 were randomly assigned to manual external chest compression (manual group, n =30), mechanical after manual chest compression(compound group, n =29)and AutoPulse mechanical chest compression ( AutoPulse group, n = 34 ). Other rescue measures were performed following the cardiopulmonary guideline of 2010. The values of PetCO2 and SPO2 at different time points of CPR, the case numbers of return of spontaneous circulation (ROSC) were recorded. According the outcomes, patients were divided into ROSC success group and failure group and the case number of each group was record. Results The rates of ROSC in compound group and AutoPulse group were both higher than that in manual group (P < 0.05). The values of PetCO2 and SPO2 at 0 min were not significantly different between ROSC success group and failure group (P > 0.05), and the values at 10 and 20 min were significantly higher in ROSC success group than those in ROSC failure group( all P <0.01). The values of PetCO2 and SPO2 at 10 min in compound group and AutoPulse group were both higher than those in manual group( P <0.01). Conclusion The device of AutoPulse can improve the tissue perfusion in patients with CA and raise the success rate of CPR, and the monitoring PetCO2 and SPO2 has a guiding and predictive value during CPR.%目的 探讨胸外按压器械AutoPulse及呼气末二氧化碳分压(PetCO2)、血氧饱和度(SPO2)监测在急诊心跳骤停患者心肺复苏(CPR)中的应用价值.方法 选择2010年12月至2011年12月在同济大学附属第十人民医院急诊科内发生心跳骤停的病例,依据按压方式随机分成徒手胸外按压组(30例)、先徒手后AutoPulse胸外按压复合组(29例)及AutoPulse胸外按压组(34例),其他抢救措施依据2010年CPR指南进行,监测复苏即刻(0min、10 min、20 min)PetCO2和SPO2测定值.同时依据是否达到自主循环恢复(ROSC),将所有病例分为ROSC成功组和失败组,分别记录例数,行统计学分析.结果 复合组与AutoPulse组ROSC成功率均大于徒手组(P＜0.05),0 min点ROSC成功组和ROSC失败组PetCO2和SPO2,差异无统计学意义(P＞0.05),10 min、20min点ROSC成功组PetCO2和SPO2均高于失败组(P＜0.05).10 min点复合组与AutoPulse组PetCO2和SPO2均高于徒手组(P＜0.01).结论 AutoPulse装置改善了心搏骤停患者的组织灌注,能提高心肺复苏成功率,CPR过程中监测PetCO2和SPO2对心肺复苏有指导和预测作用.