脉搏血氧波形衍生参数对心肺复苏质量的评估价值研究

Study on the value of pulse oximetry plethysmographic waveform derived parameters on the quality of cardiopulmonary resuscitation

目的脉搏血氧波形(pulse oximetry plethysmographic waveform,POP)为无创监测方法获得,相比于有创监测技术,其在心肺复苏期间的临床可用性更高。本研究旨在分析基于POP波形获取的三个参数:心肺复苏质量指数(CPR quality index,CQI)、灌注指数(perfusion index,PI)与按压分数(chest compression fraction,CCF)对心肺复苏质量与患者复苏可能性的评估价值。方法本研究为前瞻性描述性研究,基于74例心肺复苏病例,以患者是否自主循环恢复(return of spontaneous circulation,ROSC)将其分为ROSC组与非ROSC组。通过导出与分析临床原始数据,获取以上参数在心肺复苏过程中的分布与变化,进而研究上述参数对患者预后的临床评估价值。结果在患者复苏终末期,三个参数在两组患者间差异均有统计学意义(P<0.05)。且CQI对于复苏患者ROSC可能性的评估价值显著高于PI与CCF(P<0.05)。结论通过POP波形获取的CQI、PI与CCF参数在复苏终末期均可对心肺复苏质量与患者ROSC可能性进行评估,其中CQI的评估价值高于PI与CCF。

Objective Pulse oximetry plethysmographic(POP)waveform to indicate the patient's perfusion status and the quality of resuscitation has been affi rmed.The POP waveform is obtained by a non-invasive monitoring method,and its clinical feasibility during CPR is better than that of invasive monitoring technologies.This study aimed to analyze the three parameters derived from POP waveform:CPR quality index(CQI),perfusion index(PI),and chest compression fraction(CCF)in evaluating the CPR quality and ROSC possibility.Methods A prospective descriptive study was conducted on 74 CPR patients who were divided into the ROSC group and non-ROSC group according to their resuscitation results.The clinical data were extracted from patient monitor,the distribution and changes of the three parameters during CPR were collected,and their value of evaluating resuscitation outcome were analyzed.Results At the end stage of resuscitation,there were statistically signifi cant differences in the three parameters between the two groups(P<0.05).In addition,CQI was signifi cantly more capable in evaluating the possibility of ROSC than PI and CCF(P<0.05).Conclusions CQI,PI and CCF derived from POP waveform can all be applied to evaluate CPR quality and ROSC possibility.CQI has higher prognosis value than PI and CCF.