院内心脏骤停患者自主循环恢复的影响因素分析

Analysis of Influencing Factors of Spontaneous Circulation Recovery in Patients with Cardiac Arrest in Hospital

目的:探究院内心脏骤停(CA)患者自主循环恢复(ROSC)的影响因素。方法:采用回顾性队列研究,收集2022年1月-2022年9月急诊科救治的符合条件的院内心脏骤停患者临床资料,根据心肺复苏(CPR)结局将患者分为自主循环恢复组(ROSC组)和未恢复组(非ROSC组),分析其CA的病因并对可能影响ROSC的相关因素进行Logistic分析。结果:45例患者中,ROSC组18例,非ROSC组27例。两组是否为可除颤心律、去甲肾上腺素用量、动脉血乳酸水平、入院急性生理与慢性健康评分(APACHE II评分)、部分无创心输出量测定(USCOM)指标比较差异均有统计学意义(P<0.05)。多因素分析,结果显示APACHE II评分、心输出量(CO)是院内心脏骤停患者心肺复苏后自主循环恢复的独立影响因素(P<0.05)。结论:APACHE II评分、CO是院内心脏骤停患者心肺复苏后自主循环恢复的独立影响因素。

Objective:Toexplore the influencing factors of spontaneous circulation recovery(ROSC)in patients with cardiac arrest(CA)in hospital.Methods:A retrospective cohort study was conducted to collect the clinical data of eligible in⁃hospital cardiac arrest patients treated in the emergency department from January 2022 to September 2022.Ac⁃cording to the outcome of cardiopulmonary resuscitation(CPR),the patients were divided into spontaneous circulation recovery group(ROSC group)and spontaneous circulation non⁃recovery group(non⁃ROSC group).The etiology of CA cardiac arrest was analyzed and the related factors that may affect ROSC were analyzed by Logistic analysis.Results:Of the 45 patients,18 were in the ROSC group and 27 were in the non⁃ROSC group.There were significant differences in defibrillation rhythm,norepinephrine dosage,arterial blood lactate level,acute physiology and chronic health evalua⁃tion II(APACHE II)score and partial non⁃invasive cardiac output measurement(USCOM)between the two groups(P<0.05).Multivariate analysis showed that APACHE II score and cardiac output(CO)were independent factors affecting the recovery of spontaneous circulation after cardiopulmonary resuscitation in patients with cardiac arrest(P<0.05).Con⁃clusion:APACHE II score and CO are independent factors affecting the recovery ofspontaneous circulation after cardio⁃pulmonary resuscitation in patients with cardiac arrest.