心肺复苏中胸外按压下方波和减速波对通气质量的影响

Effects of Square Waves and Decelerating Waves on Ventilation Quality During Chest Compressions During Cardiopulmonary Resuscitation

目的探讨心肺复苏(cardiopulmonary resuscitation,CPR)期间胸外按压下方波和减速波对通气质量的影响。方法回顾性分析2022年1月—2023年8月华南理工大学附属第六医院急诊科收治的86例心搏骤停患者。依据患者所接受的不同气流速模式进行分组,将接受方波的43例患者作为对照组,接受减速波的43例患者作为研究组。比较2组的通气质量指标、呼吸力学指标、CRP效果。结果研究组≤65 cmH2O占比为100%,高于对照组的83.7%(P<0.05)。研究组气道峰压为(31.3±2.2)cmH2O,低于对照组的(40.9±2.6)cmH2O(P<0.05)。研究组心跳呼吸恢复时间为(6.3±3.1)min,短于对照组的(7.4±3.2)min(P<0.05)。结论CRP期间在胸外按压的情况下使用减速波能够使患者的气道最高峰压值水平降低,进而有效降低患者在救治过程中发生气压伤的风险及概率;与此同时,减速波下患者的相关呼吸力学指标也显著更加理想,还可缩短患者的心跳呼吸恢复时间。

Objective To explore the effects of square waves and decelerating waves on ventilation quality during chest compressions during cardiopulmonary resuscitation(CPR).Methods A retrospective analysis was performed on 86 patients with cardiac arrest admitted to the department of emergency,the Sixth Affiliated Hospital of South China University of Technology from January 2022 to August 2023.Patients were grouped according to the different gas flow modes they received.A total of 43 patients receiving square wave were used as control group and 43 patients receiving deceleration wave were used as study group.The ventilation quality index,respiratory mechanics index and CRP effect of the two groups were compared.Results The proportion of≤65 cmH2O in the study group was 100%,which was higher than 83.7%in the control group(P<0.05).The peak airway pressure in the study group was(31.3±2.2)cmH2O,lower than(40.9±2.6)cmH2O in the control group(P<0.05).The recovery time of heartbeat and respiration in the study group was(6.3±3.1)min,shorter than(7.4±3.2)min in the control group(P<0.05).Conclusion The use of deceleration waves during chest compressions during CRP can reduce the highest airway pressure level in patients,thereby effectively reducing the risk and probability of barotrauma during the treatment process.At the same time,the relevant respiratory mechanics indicators of patients under deceleration waves are significantly more ideal,which can also shorten the recovery time of their heartbeat and respiration.