目的 探讨呼气末正压(PEEP)通气对心搏骤停(SCA)患者心肺复苏的影响.方法 选择2020年1月至2022年10月SCA患者225例,随机分为观察组(102例)和对照组(105例),采用常规心肺复苏(CPR)的同时分别予PEEP,观察组:6 cmH2O,对照组:0 cm H2O,分别检测CPR期间血气分析、建立人工气道后呼气末二氧化碳分压(PetCO2)水平、ROSC成功率、7 d和28 d生存率及28 d CPC评分.结果 CPR 20 min后,观察组pH值、PaO2、PaCO2优于对照组(P<0.05).观察组PetCO2在5～30 min、自主循环恢复(ROSC)成功率及ROSC时间和7 d生存率均高于对照组(P<0.05).结论 PEEP在CPR期间能改善通气,提高患者的ROSC成功率与7 d存活率,但不能改善长期存活率及神经功能预后.
Abstract
Objective To investigate the effect of positive end-expiratory pressure ventilation on cardiopulmonary resuscitation in patients with cardiac arrest.Methods 225 patients with cardiac arrest in our hospital from January 2020 to October 2022 were retrospectively analyzed,and were randomly divided into a study group(Group A:102 patients)and a control group(Group B:105 patients).Two groups used conventional cardiopulmonary resuscitation(CPR)with positive end-expiratory pressure(PEEP).Group A set up PEEP as 6 cm H2O and group B set up PEEP as0 cm H2O.The blood gases during CPR was detected.Partial pressure of end-expiratory carbon dioxide(PetCO2)level after establishing an artificial airway,ROSC success rate,survival rate at 7 and 28 days and CPC score at 28 days were measured.Results After 20 min of CPR,the effect of group A was better than that of group B in terms of PH,PaO2,PaCO2(P<0.05).The PetCO2 in group A was higher than that of group B in 5-30 min,the success rate of restoration of autonomic circulation(ROSC),and the time of ROSC and the survival rate at 7 days(P<0.05).Conclusion PEEP improves ventilation during CPR and improves patients'ROSC success and 7-day survival,but does not improve long-term survival or neurologic prognosis.
维普
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