动态潮气末二氧化碳分压测定对原发型及窒息型心跳骤停的鉴别

Effect of dynamic partial pressure of end-tidal carbon dioxide on identification of asphyxia cardiac arrest and primary cardiac arrest

目的探讨潮气末二氧化碳分压(Pet CO2)在心肺复苏中对原发型和窒息型心跳骤停的鉴别意义。方法 82例院外心跳骤停患者根据入院时的心电图分成两组,66例患者心电图表现为直线或无脉电活动设为窒息组,16例患者心电图表现为室速或室颤设为原发组。所有患者入院后立即进行心肺复苏,在气管插管成功后马上连接Pet CO2检测仪进行Pet CO2测定,并记录作为初始值,连接呼吸机进行机械通气(潮气量6 ml/kg,频率10次/分),保持通气环境一致,持续进行Pet CO2测定至少10 min,并记录第1、2、3、5、10分钟末数值及心肺复苏结束时Pet CO2值。比较两组在7个不同时间点的Pet CO2值。结果两组患者在复苏即刻、1 min、2 min、3 min、5 min、10 min及心肺复苏结束时的Pet CO2值比较,差异均无统计学意义(t分别=1.66、1.11、1.42、1.45、1.90、1.89、1.80,P均>0.05)。结论 Pet CO2尚无法作为鉴别原发型和窒息型心跳骤停两种病因的指标。

Objective To explore the effect of dynamic partial pressure of end-tidal carbon dioxide （PetCO2） on identification of asphyxia cardiac arrest and primary cardiac arrest. Methods A total of 82 patients with out-of-hospital cardiopulmonary arrest were categorized in two groups based on the initial presenting ECGs. 66 patients with initial rhythm asystole or pulseless electrical activity enrolled as the asphyxia group,and 16 patients with initial rhythm VF or pulseless VT as the primary group. All patients were performed standard CPR immediately. Further ventilation was performed by mechanical ventilator （6 ml/kg at 10 breaths/min） after endotracheal intubations. The PetCO2 was measured for both groups immediately after intubation as initial PetCO2, and then repeatedly 1st,2nd,3rd,5th,10th minutes and the time CPR was end as final PetCO2. The values of PetCO2 at 7 different points were compared. Results The values of PetCO2 had not significant differences at 7 different points （t=1.66,1.11,1.42,1.45,1.90,1.89,1.80,P〉0.05）. Conclusion PetCO2 cannot be as identified index of asphyxia cardiac arrest and primary cardiac arrest.