心搏骤停患者心肺复苏过程中呼气末二氧化碳分压监测的临床意义

Clinical significance of end-tidal carbon dioxide partial pressure monitoring during cardiopulmonary resuscitation in patients with cardiac arrest

目的探讨呼气末二氧化碳分压(P_(ET)CO_2)监测在评估心搏骤停(CA)患者心肺复苏(CPR)质量及临床预后中的临床意义。方法 70例行CPR治疗的心搏骤停患者作为研究对象,所有患者在CPR过程中均采用谊安VG70多参数中央监护仪监测P_(ET)CO_2,将CPR成功患者设为成功组,CPR失败患者设为未成功组,比较成功组与未成功组患者不同复苏时间的P_(ET)CO_2,将CPR成功患者根据临床预后分为存活组和死亡组,比较存活组和死亡组患者不同复苏时间的P_(ET)CO_2。结果 70例行心CPR治疗的CA患者共有8例患者自主循环恢复,CPR成功率为11.43%。CPR成功组患者复苏15 min、30 min的P_(ET)CO_2均明显高于未成功组,差异具有统计学意义(P<0.05),且随时间延长P_(ET)CO_2逐渐增高。8例CPR成功患者最终存活出院3例(37.5%),死亡5例(62.5%)。存活组患者复苏15 min、30 min的P_(ET)CO_2均明显高于死亡组,差异具有统计学意义(P<0.05),且随时间延长P_(ET)CO_2逐渐增高。结论 P_(ET)CO_2监测在评估心搏骤停患者CPR质量及临床预后方面具有重要的临床意义,CPR过程中P_(ET)CO_2水平越高,提示CPR质量及临床预后越好。

Objective To investigate the clinical significance of end-tidal carbon dioxide partial pressure(PETCO2)monitoring in the evaluation of the quality and clinical prognosis of cardiopulmonary resuscitation(CPR)in patients with cardiac arrest(CA).Methods A total of 70 CA patients with CPR treatment were selected as research objects.PETCO2 of all patients were monitored with the Yi-an VG70 multi-parameter central monitor in the CPR process.Patients with successful CPR were set up as successful group,patients with CPR failure were set up as unsuccessful group,and PETCO2 at different resuscitation time between CPR successful group and unsuccessful group were compared.Patients with successful CPR were divided into survival group and death group according to clinical prognosis,and PETCO2 at different resuscitation time were compared between survival group and death group.Results There were a total of 8 patients with autonomous cycle recovery in 70 CA patients with CPR treatment.The success rate of CPR was 11.43%.The PETCO2 of CPR successful group at 15 min and 30 min after resuscitation were significantly higher than those in the unsuccessful group,the differences were statistically significant(P<0.01),and PETCO2 gradually increased with time.There were 3 patients(37.5%)final survival and discharge and 5 patients(62.5%)died in 8 patients with successful CPR,and the PETCO2 of survival group at 15 min and 30 min after resuscitation were significantly higher than those in the death group,the differences were statistically significant(P<0.01),and PETCO2 gradually increased with time.Conclusion PETCO2 monitoring has important clinical significances in the evaluation of the quality and clinical prognosis of CPR in CA patients,The higher PETCO2 level during CPR,the better CPR quality and clinical prognosis.