呼气末二氧化碳分压联合按压分数连续监测用于评估院内心肺复苏质量和效果的临床价值

The clinical value of end-tidal carbon dioxide partial pressure combined with compression fraction continuous monitoring in evaluating the quality and effect of in-hospital cardiopulmonaryy resuscitation

目的 通过连续监测院内非创伤性心脏骤停(CA)患者心肺复苏(CPR)质量期间呼气末二氧化碳分压(PETCO_(2))和按压分数(CCF)评估院内CPR质量及效果的临床价值,为高质量CPR技术实施与决策提供依据.方法 纳入2022年1月-2024年5月成飞医院急诊科收治的符合纳入排除标准的非创伤性心脏骤停患者为研究对象,根据是否出现持续自主循环恢复分为ROSC组与非ROSC组.收集患者临床资料和急诊数据,采用多因素Logistic回归模型分析CCF和PETCO_(2)与患者ROSC的关系;受试者工作特征曲线(ROC)分析评估两种指标对复苏结局的预测效能,并计算曲线下面积(AUC).结果 ROSC组按压暂停时间显著少于非ROSC组(P<0.05).与非ROSC组相比,ROSC组的总CCF更高(P<0.05),插管时PETCO_(2)和PETCO_(2)平均值更高(P<0.05).按压暂停时间、总CCF、PETCO_(2)平均值是CA患者CPR后ROSC的影响因素(P<0.05);ROC曲线结果表明预测CA患者CPR后ROSC的效能的效果为:PETCO_(2)平均值>总CCF>按压暂停时间.结论 呼气末二氧化碳分压联合按压分数连续监测是一种有效评估院内心肺复苏质量和效果的方法.

Objective To evaluate the clinical value of the quality and effect of in-hospital CPR by continuously monitoring the quality of PerCO_(2) and CCF during CPR in patients with non-traumatic CA in hospital,so as to provide a basis for the implementation and decision-making of high-quality CPR technology.Methods Patients with non-traumatic cardiac arrest who met the inclusion criteria in the emergency department of Chengfei Hospital from January 2022 to May 2024 were enrolled as the study subjects,and were divided into ROSC group and non-ROSC group according to whether there was continuous spontaneous circulation recovery.Clinical data and emergency data were collected,and the relationship between CCF and PerCO_(2) and ROSC was analyzed by multivariate Logistic regression model.ROC curve analysis was used to evaluate the predictive power of the two measures for resuscitation outcomes,and the AUC was calculated.Results The compression pause time in the ROSC group was significantly less than that in the non-ROSC group(P<0.05).Compared with the non-ROSC group,the total CCF was higher in the ROSC group(P<0.05),and the mean values of PerCO_(2) and PerCO_(2) were higher at intubation(P<0.05).Compression pause time,total CCF and PerCO_(2) mean values were the influencing factors of ROSC after CPR in CA patients(P<O.05).The results of the ROC curve showed that the efficacy of ROSC afier CPR in CA patients was as follows:mean PerCO_(2)>total CCF>compression pause time.Conclusion End-tidal carbon dioxide partial pressure combined with continuous monitoring of fractional compressions is an effective method to evaluate the quality and effect of in-hospital cardiopulmonary resuscitation.