BACKGROUND:Active compression-decompression cardiopulmonary resuscitation(ACDCPR) has been popular in the treatment of patients with cardiac arrest(CA).However,the effect of ACD-CPR versus conventional standard CPR(S-...BACKGROUND:Active compression-decompression cardiopulmonary resuscitation(ACDCPR) has been popular in the treatment of patients with cardiac arrest(CA).However,the effect of ACD-CPR versus conventional standard CPR(S-CRP) is contriversial.This study was to analyze the efficacy and safety of ACD-CPR versus S-CRP in treating CA patients.METHODS:Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase "active compression-decompression cardiopulmonary resuscitation and cardiac arrest" in PubMed,EmBASE,and China Biomedical Document Databases.The Cochrane Library was searched for papers of meta-analysis.Restoration of spontaneous circulation(ROSC) rate,survival rate to hospital admission,survival rate at 24 hours,and survival rate to hospital discharge were considered primary outcomes,and complications after CPR were viewed as secondary outcomes.Included studies were critically appraised and estimates of effects were calculated according to the model of fixed or random effects.Inconsistency across the studies was evaluated using the I2 statistic method.Sensitivity analysis was made to determine statistical heterogeneity.RESULTS:Thirteen studies met the criteria for this meta-analysis.The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP.Totally 234 CA patients were found out hospitals,while the other 333 CA patients were in hospitals.Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality.ROSC rate,survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP,with relative risk(RR) values of 1.39(95%CI 0.99-1.97),1.94(95%CI 1.45-2.59) and 2.80(95%CI 1.60-5.24).No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06(95%CI 0.76-1.60) and 1.00(95%CI 0.73-1.38).CONCLUSION:Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours.Compared with S-CRP,ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge.展开更多
We established a rat model of cardiac arrest by clamping the endotracheal tube of adult rats at expiration. Twenty-four hours after cardiopulmonary resuscitation, nerve cell injury and expression of tumor necrosis fac...We established a rat model of cardiac arrest by clamping the endotracheal tube of adult rats at expiration. Twenty-four hours after cardiopulmonary resuscitation, nerve cell injury and expression of tumor necrosis factor-α, interleukin-1β, and p38 mitogen activated protein kinase content were increased. Rats injected with Xuebijing, a Chinese herb compound preparation, exhibited normal cellular structure and morphology, dense neuronal cytoplasm, and decreased tumor necrosis factor-α, interleukin-1β, and p38 mitogen activated protein kinase expression at 24 hours following cardiopulmonary resuscitation. These data suggest that Xuebijing can attenuate neuronal injury induced by hypoxia and reperfusion during cardiopulmonary resuscitation.展开更多
The American Heart Association and the European Resuscitation Council recently recommend- ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discu...The American Heart Association and the European Resuscitation Council recently recommend- ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopul- monary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Iun N-terminal kinase and p38 expression were significantly decreased in the hippo- campus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No significant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Iun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation.展开更多
文摘BACKGROUND:Active compression-decompression cardiopulmonary resuscitation(ACDCPR) has been popular in the treatment of patients with cardiac arrest(CA).However,the effect of ACD-CPR versus conventional standard CPR(S-CRP) is contriversial.This study was to analyze the efficacy and safety of ACD-CPR versus S-CRP in treating CA patients.METHODS:Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase "active compression-decompression cardiopulmonary resuscitation and cardiac arrest" in PubMed,EmBASE,and China Biomedical Document Databases.The Cochrane Library was searched for papers of meta-analysis.Restoration of spontaneous circulation(ROSC) rate,survival rate to hospital admission,survival rate at 24 hours,and survival rate to hospital discharge were considered primary outcomes,and complications after CPR were viewed as secondary outcomes.Included studies were critically appraised and estimates of effects were calculated according to the model of fixed or random effects.Inconsistency across the studies was evaluated using the I2 statistic method.Sensitivity analysis was made to determine statistical heterogeneity.RESULTS:Thirteen studies met the criteria for this meta-analysis.The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP.Totally 234 CA patients were found out hospitals,while the other 333 CA patients were in hospitals.Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality.ROSC rate,survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP,with relative risk(RR) values of 1.39(95%CI 0.99-1.97),1.94(95%CI 1.45-2.59) and 2.80(95%CI 1.60-5.24).No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06(95%CI 0.76-1.60) and 1.00(95%CI 0.73-1.38).CONCLUSION:Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours.Compared with S-CRP,ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge.
基金a grant from the Science and Technology Department of Jilin Province,No. 200705172
文摘We established a rat model of cardiac arrest by clamping the endotracheal tube of adult rats at expiration. Twenty-four hours after cardiopulmonary resuscitation, nerve cell injury and expression of tumor necrosis factor-α, interleukin-1β, and p38 mitogen activated protein kinase content were increased. Rats injected with Xuebijing, a Chinese herb compound preparation, exhibited normal cellular structure and morphology, dense neuronal cytoplasm, and decreased tumor necrosis factor-α, interleukin-1β, and p38 mitogen activated protein kinase expression at 24 hours following cardiopulmonary resuscitation. These data suggest that Xuebijing can attenuate neuronal injury induced by hypoxia and reperfusion during cardiopulmonary resuscitation.
文摘The American Heart Association and the European Resuscitation Council recently recommend- ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopul- monary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Iun N-terminal kinase and p38 expression were significantly decreased in the hippo- campus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No significant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Iun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation.
